NSO

DIVINE MERCY MEDICAL CENTER* DIVINE MERCY MEDICAL CENTER ** ILOILO CITY, PHILIPPINES * 2009 *

Diversion Road, Mandurriao, Iloilo City

Nursing Services DivisionDescriptionThe Nursing Service, as an integral part of the Divine Mercy Medical Center, accepts that its primary functions are focused on service to the community; participation in the education of students and practitioners of nursing, medicine and other health disciplines; promotion of research to increase knowledge and improve patient care.The role our nurses play in the success of your treatment, and in your entire healing process, can never be underestimated. Our professional nurses and their assistants are at the frontline of patient care, and we at recognize this and act accordingly. By taking care of our nurses, we are able to provide you with exceptional patient care. We value the contribution of our nurses to our successand reward them. We start off by choosing the right people from the thousands of nursing graduates who apply to train with us. We only hire nurses from the outstanding and high performing schools. We then inspire them with the innovative vision of outstanding patient care first envisioned by the celebrated 19th century British nurse Florence Nightingale. As we know that meritocracy encourages hard work and efficiency, we let all our nurses undergo a competency-based trainingand their job description and appraisal system is also clearly competency-based, serving to motivate and encourage them. This rigorous training is also meant to break up their old way of thinking and help them shift into a distinct nursing paradigm that combines an equal measure of quick wits, a compassionate heart and hard manual work. Because we recognize that the main part of the responsibility to create and maintain a safe and healing environment for patients falls on our nurses, our training does not only teach them to be clinically proficient. Instead, we train our nurses to be leadersto have the authority and autonomy to make decisions that could save lives.

The Department of Nursing Vision Statement: NURSEVISION

It is dedicated to promote Nursing professional development and Utilization of patient-centered care practice with Research-based and innovations, Safety initiatives and Excellent caring service globally through collaborative relationships.

MISSION

Nursing Service Department is committed to provide the highest quality patient-centered care through evidence-based practice, advancement in professional nursing practice, research, innovations, education and continued pursuit of nursing quality for global excellence. These are guided by the Nursing as Caring theory.

CORE VALUESThe Department of Nursing Values Statement

PATIENT-CENTERED CAREWhile the quality of care is uniform and improved and as a health care professional who are competent, care may be modified according to patients needs, choices, preferences and values. AUTONOMYThe patient has a significant role in determining the course of his or her care. Health professionals should communicate effectively, ensuring that patients have adequate information to make informed decisions and encourage shared decision making, participation and sovereignty.

TEAMWORKCooperation among health care professionals is one of the priorities. Acknowledging the contributions of all but requires sacrifice through sharing ideas and responsibilities in an environment of mutual respect for the benefit of the patient so as to enhance the health and works to achieve our aspirations and goals.INNOVATIONS AND EVIDENCE-BASED CAREDecisions regarding in providing the best care are based on the best available scientific acceptable standardized knowledge, evidence practice and innovations through research and theory which undergone systematic and scientific process with the aid of our advanced, state of the art and high technological facilities and equipments.

EXCELLENCEWe are committed to provide our patients with excellent standards of service, medical care and satisfaction through client and family partnerships, participation and collaboration among health care professionals in order to exceed the community's expectations of excellence. Health professionals should provide care and be responsive at all times.

NURTURE AND CONTINUUM OF CAREPatients needs should be anticipated whenever possible. Health professionals should do their best to anticipate patient needs through patient collaboration, partnership and interpersonal relationship and their representatives to ensure patients satisfaction, continuity of high quality care and their conditions are at the best state.

TRUST, RESPECT and COMPASSIONHealth professionals should deliver care with respect and compassion with an environment of trust, openness and cooperation. We are committed to provide patients and the community the highest standards of respect, compassion and clinical excellence. We are exceptional professionals called to do exceptional duty.

SAFETY AND STANDARDSPatient safety is a top priority at all times. Health professionals should strive to enhance safety by continuously paying close attention to procedural and operational systems and by following policies and procedures that help prevent and mitigate errors.

Figure 1. Paradigm or framework showing the vision, mission and core values of Nursing Service Department.

Nursing Philosophy

We believe that Nursing is united by:A personal commitment to caringA dynamic search for professional excellence through innovation A team spirit of trust, compassion and respect in our interaction with mankind

The Key Components of Our Practice:1. Caring and Compassionate Environment2. Professional excellence3. Continuum of Care4. Respect, trust and compassionate approach to Health and Wellness5. Evidence-based Practice and innovation6. Sensitivity for Customer Service, Outcomes and Cost7. Advocacy8. Collaboration across disciplines9. Autonomy

Goal:

Optimal Patient Care Experience for every patient and family member through service excellence, patient-centered care practice, innovations, partnership, communication, and corporate values.

Figure 2. Paradigm or framework showing the goal and its core component of the Nursing Service Department.OBJECTIVES

General:

Nursing Service is committed to promote holistic and excellent quality patient care and service to meet patients expectations, needs, and preferences.

Specific:

Nursing service specifically aimed: To provide excellence inpatient care that is comprehensive and sensitive to their social, emotional, cultural and physical needs. To recruit, retain and develop nursing staff in a progressive environment that provides challenges and fosters creativity, personal/professional growth and displays performance of service standards. To ensure optimal quality of patient care through objective, systematic monitoring using established standards and criteria-based evaluations. To measure the effectiveness of nursing research through ongoing investigation and implementation of concepts and theories designed to improve patient care. To provide care to patients with acute and chronic illness, patient education, illness prevention, health maintenance, discharge planning and palliative care.CORE COMPETENCIESOur nurses are trained in 12 areas of competence: 1. Safe and quality nursing 2. Management of environment and resources 3. Health and education 4. Legal responsibility 5. Ethico-moral responsibility 6. Personal and professional development 7. Quality improvement 8. Research 9. Records management 10. Communication 11. Collaboration and teamwork 12. Customer service Our nursing services training curriculum is meant to develop these 12 core competencies. These competencies also serve as the: practical tool for evaluation performance of nurses basis for advanced practice and specialization means to protect the public from incompetent practitioners yardstick for unethical and unprofessional practice Finally, by empowering them to be leaders in their respective units, and providing them with an attractive career path of both clinical and managerial positions, we ensure that they are motivated to stay with us through the years. Because of this, we can guarantee that at a time when most nurses have imbibed the impersonal values of the industrialized worldour nurses are some of the worlds best, still embodying the care and compassion of older days. As proof to our claim, Nursing Services has consistently rated high in the patient satisfaction index through the years.PHILOSOPHYWe, at the Nursing Service Division of the Divine Mercy Medical Center believes that nursing is an individualized process of caring for and supporting patients as they progress through the changing level of health.Our nursing staff believes:1. That its major contribution to society is the provision of professional nursing care that is a direct personal service toward individuals and families with problems of health-illness nature.Nursing Care involves among others the process of identification of patient problems through systematic assessment and meeting of client needs through careful planning and evaluation. It believes further that the practice of nursing like other health disciplines, demands professional responsibility, commitment and "oughtness" from those who engage in its practice.2. In the intrinsic worth and dignity of individual, thereby recognizing the client's needs, goals, potentialities, individuality and integrity.

Likewise, it believes that the client lives within a society whose culture affects his ways of doing things and therefore, in the process of planning and carrying out his nursing care, these factors are taken into consideration.

3. That everyone should be treated with dignity, courtesy and compassion; that quality of care should be unaffected by race, culture and religious belief. The rights of patients must be respected and their physical, psychological and spiritual health must be valued.

4. That it shall foster a climate conducive to continued professional and intellectual growth of the nursing personnel to further develop their potentialities and capabilities so that they may be able to initiate changes in terms of desirable goals of society as well as conserve the desirable aspects of the Filipino cultural heritage.

5. In the support of research in nursing and participation in investigations for the improvement of client care.Ways to achieve exceptional nursing careWe realize that excellence in nursing care is only assured when we continuously and regularly: 1. Recognize that the scope of their work extends throughout all areas of operation, encompassing clinical skills, caring, customer relations and even financial and logistics planning. 2. Nurture our nurses and cultivate their skills through continuing education, research. 3. Empower them to make decisions. 4. Grant them a clear and attractive career path. 5. Evaluate our nursing services, and modify work protocols, nursing policies and procedures to place them in line with ever-increasing global standards. The Nursing Services Division has the following units: Standard Nursing Units Critical Care and Intensive Care, Operative Services, Emergency / Outpatient Services Professional Development and Training We also have special training for pain management, oncology and cardiovascular, peritoneal and hemodialysis training and the triage nursing training.

BALANCE SCORECARDSNIATTEPIt is dedicated to promote Nursing professional development and Utilization of patient-centered care practice with Research- based and innovations, Safety initiatives and Excellent caring service globally through collaborative relationships.3. Capture new revenue.2. Increase annual operating margin percent.1. Grow revenue from existing and potential markets.4. Recruit and retain a team of highly skilled patient focused professionals.3. Create a culture of customer service excellence.1. Develop a culture of teamwork.2. Develop a culture of work place and safety.4. Identify, prioritize and deliver value- added services.3. Build and empower a team of exceptional patient advocates.1. Patient- centered care.2. Be a resource for health education and support.1. Sustain high standards of healthcare ethics.2. Develop a culture of patient safety.3. Create and sustain a Culture of excellence defined by standards of care.

NURSINGNursing is an art of applying scientific principles in an intelligent humanitarian way to the care of people experiencing potentially maladaptive stress A professional service that has sound knowledge base gleaned from both social and physical sciences.

THE UNIQUE FUNCTION OF NURSINGThe unique function of the nurse is to assist the individual, sick or well, in the performance of the activities contributing to health or his recovery (or to a peaceful death) that he would do unaided if he had the necessary strength, will or knowledge, and to do this in such a way as to help him gain independence as rapidly as possible. This aspect of her work, she initiates and controls, of this she is mater.CONCEPTS OF NURSING ETHICSNursing ethics is that aspect of moral philosophy which serves as guide in ones judgment or appraisal of the goodness or badness of acts relative to the practice of nursing. Nursing ethics is often times associated or considered synonymous with nursing etiquette. In a larger sense, however, nursing ethics is concerned not only with etiquette but with moral principles or moral conduct.The practice of nursing is a profession predicated on the ideals of service. It is a vocation premised on personal sacrifices and devotion to duty for the benefit of the people while the profession is a means of livelihood and a professional nurse has an inherent right to earn a living and secure for herself the necessities and comforts of life, so as to enable her to perform her work well and place herself in proper estimation in the community in which she lives, she should not however forget that as a practitioner her primary object is not to amass financial gains but to render satisfactory professional service.

THE ICN CODE OF ETHICS FOR NURSESPREAMBLE

Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal.

Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, color, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status.

Nurses render health services to the individual, the family and the community and co-ordinate their services with those of related groups.

ELEMENTS OF THE CODE

I. NURSES AND PEOPLEThe nurses primary professional responsibility is to people requiring nursing care. In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected.The nurse ensures that the individual receives sufficient information on which to base consent for care and related treatment.The nurse holds in confidence personal information and uses judgment in sharing this information.

The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations.

The nurse also shares responsibility to sustain and protect the natural environment from depletion, pollution, degradation and destruction.

II. NURSES AND PRACTICEThe nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning.The nurse maintains a standard of personal health such that the ability to provide care is not compromised.The nurse uses judgment regarding individual competence when accepting and delegating responsibility.The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence.The nurse, in providing care, ensures that use of technology and scientific advances are compatible with the safety, dignity and rights of people.III. NURSES AND THE PROFESSIONThe nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education.

The nurse is active in developing a core of research-based professional knowledge.

The nurse, acting through the professional organization, participates in creating and maintaining safe, equitable social and economic working conditions in nursing.

IV. NURSES AND CO-WORKERSThe nurse sustains a co-operative relationship with co-workers in nursing and other fields.

The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a coworker or any other person.

USE OF THE CODE OF ETHICS FOR NURSESThe Code of Ethics for Nurses is a guide for action based on social values and needs. It will have meaning only as a living document if applied to the realities of nursing and health care in a changing society.

To achieve its purpose the Code must be understood, internalized and used by nurses in all aspects of their work. It must be available to students and nurses throughout their study and work lives.

APPLYING THE ELEMENTS OF THE CODE OF ETHICS FOR NURSESThe four elements of the ICN Code of Ethics for Nurses: nurses and people, nurses and practice, nurses and the profession, and nurses and co-workers, give a framework for the standards of conduct. The following chart will assist nurses to translate the standards into action. Nurses and nursing students can therefore: Study the standards under each element of the Code.

Reflect on what each standard means to you. Think about how you can apply ethics in your nursing domain: practice, education, research or management.

Discuss the Code with co-workers and others.

Use a specific example from experience to identify ethical dilemmas and standards of conduct as outlined in the Code. Identify how you would resolve the dilemmas.

Work in groups to clarify ethical decision making and reach a consensus on standards of ethical conduct.

Collaborate with your national nurses association, co-workers, and others in the continuous application of ethical standards in nursing practice, education, management and research.

Element of the Code # 1: NURSES AND PEOPLE

Practitioners and ManagersEducators and ResearchersNational Nurses Associations

Provide care that respects human rights and is sensitiveto the values, customs and beliefs of all people.In curriculum include references to human rights, equity, justice, solidarity as the basis for access to care.Develop position statements and guidelines that support human rights and ethical standards.

Provide continuing education in ethical issues.Provide teaching and learning opportunities for ethical issues and decision making.Lobby for involvement of nurses in ethics review committees.

Provide sufficient information to permit informed consent and the right to choose or refuse treatment.Provide teaching/learningOpportunities related to Informed consent.Provide guidelines, position statements and continuing education related to informed consent.

Use recording and information management systems that ensure confidentiality.Introduce into curriculum concepts of privacy and confidentiality.Incorporate issues of confidentiality and privacy into a national code of ethics for nurses.

Develop and monitor environmental safety in the workplace.Sensitize students to the importance of social action in current concerns.Advocate for safe and healthy environment.

Element of the Code # 2: NURSES AND PRACTICE


Establish standards of care and a work setting that promotes safety and quality care.Provide teaching/learning opportunities that foster lifelong learning and competence for practice.Provide access to continuingeducation, through journals, conferences, distance education, etc.

Establish systems for professional appraisal, continuing education and systematic renewal of licensure to practice.Conduct and disseminate research that shows links between continual learning and competence to practice.Lobby to ensure continuing education opportunities and quality care standards.

Monitor and promote the personal health of nursing staff in relation to their competence for practice.Promote the importance of personal health and illustrate its relation to other values.Promote healthy lifestyles for nursing professionals. Lobby for healthy work places and services for nurses.

Element of the Code # 3: NURSES AND THE PROFESSION


Set standards for nursing practice, research, education and management.Provide teaching/learning opportunities in setting standards for nursing practice, research, education and management.Collaborate with others to set standards for nursing education, practice, research and management.

Foster workplace support of the conduct, dissemination and utilization of research related to nursing and health.Conduct, disseminate and utilize research to advance the nursing profession.Develop position statements, guidelines and standards related to nursing research.

Promote participation in national nurses associations so as to create favorable socio-economic conditions for nurses.Sensitize learners to the importance of professional nursing associations.

Lobby for fair social and economic working conditions in nursing. Develop position statements and guidelines in workplace issues.

Element of the Code #4: NURSES AND CO-WORKERS


Create awareness of specific and overlapping functions and the potential for interdisciplinary tensions.Develop understanding of the roles of other workers.Stimulate co-operation with other related disciplines.

Develop workplace systems that support common professional ethical values and behavior.Communicate nursing ethics to other professions.Develop awareness of ethical issues of other professions.

Develop mechanisms to safeguard the individual, family or community when their care is endangered by health care personnel.Instill in learners the need to safeguard the individual, family or community when care is endangered by health care personnel.Provide guidelines, position statements and discussion fora related to safeguarding people when their care is endangered by health care personnel.

NSO ORGANIZATIONAL STRUCTURE

CHIEF EXECUTIVE OFFICER

NURSING DIRECTOR

ASSISTANT NURSING DIRECTOR

NURSE SUPERVISOR(OR, RR, DR, NICU)

NURSE SUPERVISOR(CLINICAL AREA)

NURSE SUPERVISOR(INSTRUCTOR)NURSE SUPERVISOR(OPD, ER)

NURSE INSTRUCTORHEAD NURSEHEAD NURSEHEAD NURSE

TRAINEESSTAFF NURSESSTAFF NURSESSTAFF NURSES

MIDWIVESNURSING ATTENDANTS

NURSING ATTENDANTS

NURSING ATTENDANTS

INSTITUTIONALWORKERS



ORGANIZATIONAL CHARTThis is a pyramidal or vertical type of an organizational chart. It shows the nursing director having the highest form of authority in the unit. The solid vertical lines show that the authority flows from the Director of Nursing to the nurse supervisor then to the head nurse and to the front line nurses, nursing attendants and institutional workers. The authority from the head nurse flows down to the staff nurses representing the different units. The relationship of the head nurse to the senior nurses and their corresponding staff nurses becomes more effective and it suggests better coordination and effective communication. The solid horizontal lines do not convey any authority rather suggests equal placement and authority in the line of organization.The organizational structure has a top down flow of authority and communication. Even though staff nurses have no direct authority to their head nurse, staff nurses could have an upward communication with regards to schedule requests, reports and other responsibilities. The chain of command does not suggest direct authority by the staff nurse to the nursing attendants and institutional workers. Nursing attendants and institutional workers report for duty to the head nurse. The staff nurses and the nurse attendants do not have any direct form of authoritarian relationship with each other.Centrality in the organizational structure indicates the location of a position where frequent communication occurs. Staff nurses have shorter organizational distance than nursing attendants have and it means that staff nurses are able to get broader bits of information from the top authority than nursing attendants. The type of organization utilizes a narrow span of control. The organization of the staff nurses for each unit is lead by the senior nurses who have stayed in the hospital and in the unit for quite some time though not directly specified in the chart. Senior nurses act as leaders only in the implementation of the directives received from the head nurse but have no direct authority in the management of staff performance and prescribed job. Senior nurses only aid the head nurse in the operational management of the units of the complex. The members are given the opportunity to enhance their skills and expand their knowledge in different areas of nursing. In every change of schedule, the mix of nursing personnel also changes. Nurses, nursing attendants and institutional workers rotate among each units of the hospital as stipulated in the staffing modality of the hospital.

NURSING ADMINISTRATIONIt is the process through which the full latent capacity of nurses and of related professionals and supporting personnel, of facilities and environment, and of social action are developed in a systematic way to improve the health of the people.Nursing Service OfficeThe Nursing Service Office shall be headed by a Director of Nursing. The Director of Nursing is responsible for the design of the entire program of the administration and supervision in relation to nursing service.Functions and Duties:1. Plans, organizes and supervises the nursing service in order to provide nursing care to patients.2. Responsible for the assignment of duties and schedule of personnel in the nursing department.3. Coordinates all activities of the nursing service department with other department.4. Participates in the preparation of nursing service budget to provide adequate personnel,, supplies, equipment, and physical facilities.5. Observes and evaluates the performance of personnel as well as analyses and evaluates nursing activities to determine whether they are meeting desired standards.6. Interviews and screens all applicants for the nursing service, and evaluates their qualifications and experiences and recommends them to the Selection and Promotions Board.The Nursing Service is concerned with the practice of professional nursing which according to law shall for a fee, salary or other reward or compensation, or even without the same, perform professional services such as:1. Undertaking responsible nursing care with supervision of medical, communicable, mental health, psychiatric patients, surgical, orthopedic, eye-ear-nose and throat, emergency, urologic and gynecologic, pediatric and obstetric patients involving the whole management of care, requiring the application of principles based upon the biologic, the physical and social sciences.2. The observation of symptoms of physical and mental conditions and needs requiring evaluation or application of principles based upon the biologic, the physical and social sciences.3. The accurate reporting and recording of facts including evaluation of the whole care.4. The supervision of others contributing to the nursing care of patients.5. The execution of nursing procedures and techniques.6. The application and execution of legal orders concerning treatments and medications with an understanding of causes and effects.7. Formulates and recommends policies for the improvement of patient care.8. Participates in planning of personnel policies and interprets the needs and interests of nursing personnel.9. Promotes individual growth and development by maintaining a program of staff education and research.10. Promotes and maintains cordial relationship with patients, their families and the community and provides opportunities for nursing staff to work with other groups so that the aims of the hospital can be achieved through good interpersonal and interdepartmental relationship.11. Participates in professional meetings as the representative of the nursing service personnel.12. Provides for healthful living conditions of nursing personnel and prepares and submits nursing service reports as needed.

JOB DESCRIPTIONJob Title: Director of Nursing (Nurse V)Job Summary:A registered nurse with masters degree who is responsible for the whole nursing division of the hospital. The Director of Nursing reports to the immediate supervisor, which is the Hospital Administrator and coordinates with the Medical Director, College of Nursing and other heads of Offices of the hospital.

Qualification Requirementa. Competence in the field in which the individual has specialized particularly on administrative and supervisory skills including ability to give good nursing care and to cooperate with members of the nursing staff as well as to coordinate her part of the program with theirs.b. Acceptable personality and professional qualities essential for leadership.c. Integrity of mind and character, ability to grow and adjust with others.d. Good mental and physical health.e. Participation in community activities.f. Must be above average of her professional group in intelligence, uses her mind and knowledge effectively in improving her nursing practice.g. Must be a registered nurse in the Philippinesh. Have at least two (2) years experience as a staff nurse.i. Have at least three (3) years in clinical managerial positionj. Have at least five (5) years experience in a supervisory or managerial position in nursingk. Have atleast two (2) years in Chief Managerial Positionl. Possess a degree of Bachelor of Science in Nursing, with a degree of Master of Arts in Nursing Major in Nursing Service Administration and Health Services Administration.m. Be a member of good standing of the accredited professional organization of nurses. n. Be a holder of masters degree major in Nursing, or its equivalent.o. Must have BLS training in any institution in the country.p. Must be a licensed IV therapy preceptor.Trainings, seminars and workshops attendedTraining needs

Basic Nursing Programs, Decentralized Programs,Specialty Program, Progressive Clinical Nursing Program, Postgraduate Courses programs,National Association of Directors of Nursing Administration in Long Term Care program certification, Behavioral Health Case Management

Duties and ResponsibilitiesPlanning Prepares strategic and operational plan in congruence with the objectives of the organization. Established nursing standards (Structure, criteria standards), policies and procedures of the organization. The Director of Nursing also developed, in congruence with the policies, the nursing service policies and manual that each nursing department will used for uniformity in practice. Approved and developed scheduling programs for each nursing department, and prepares the budget in line with the strategic and operational plan the organization ensues. Coordinates with the top management, for organizational plan and changes that the top management wants to pursue, and coordinates accordingly for forecasting purposes in response and preparation for future accreditations, in cooperation with the Quality Control Team.

Organizing Conforms and coordinates with the hospital director and the Management is setting up the Organizational Structure for the organization. Determines staffing needs for each unit in coordination with the clinical supervisors of each nursing unit. Organize nursing schedules in collaboration with the clinical supervisors.

Directing Delegates specific duties and responsibilities to clinical supervisors and the nurses alike in the performance of their duties and responsibilities. Directs the nursing care assignment. Supervise the Nursing Service Office. Prepares and directs necessary communication for all nursing units in accordance with the goals of the organization. Coordinates and reports directly to the medical director, and coordinates with the ancilliary services, administrative services, medical records, medical social services, and other institutions in directing the nursing service office. Responsible for staff development of each nurses, may it be in-service trainings and the like. Responsible in directing and solving conflict management, and sentinel events within the organization in collaboration with the sentinel event analysis team.

Controlling Conducts evaluation and Performance Appraisals every 3 months. Established standards for nursing performance. Maintains quality assurance within the organization, in coordination with the CQI Director. Conducts Nursing Audit every month. Plays an active role in employee discipline.

JOB DESCRIPTIONJob Title: Assistant Director of Nursing (Nurse IV)

Job Summary:A registered nurse who assists the Nursing Director in managing the whole nursing personnel workforce in the hospital. The Assistant Director of Nursing is also the Continuous Quality Assurance Nurse. He/She reports to the immediate supervisor, which is the Nursing Director or the Medical Director.

Qualifications:a. Competence in the field in which the individual has specialized particularly on administrative and supervisory skills including ability to give good nursing care and to cooperate with members of the nursing staff as well as to coordinate her part of the program with theirs.b. Acceptable personality and professional qualities essential for leadership.c. Integrity of mind and character, ability to grow and adjust with others.d. Good mental and physical health.e. Participation in community activities.f. Must be above average of her professional group in intelligence, uses her mind and knowledge effectively in improving her nursing practice.g. Must be a registered nurse in the Philippinesh. Have at least two (2) years experience as a staff nurse.i. Have at least three (3) years in clinical managerial positionj. Have at least five (5) years experience in a supervisory or managerial position in nursingk. Possess a degree of Bachelor of Science in Nursing and a degree of Master of Arts in Nursing Major in Nursing Service Administration.l. Be a member of good standing of the accredited professional organization of nurses.m. Must have BLS training in any institution in the country.n. Must be a licensed IV therapy preceptor.

Trainings, seminars and workshops attendedTraining needs

Basic Nursing Programs, decentralized Programs,Specialty Program, Progressive Clinical Nursing Program, Leadership Training, Communication And Critical Thinking,

Postgraduate Courses programs, National Association of Directors of Nursing Administration in Long Term Care program certification, Behavioral Health Case Management

Duties and Responsibilities1. Plans, organizes and supervises the nursing service in order to provide adequate nursing care to patients.2. Collates and reviews report and recommendation submitted to the office.3. Guides the nursing service personnel in the investigation of issues, problems and concern which may exist in the clinical area.4. Participates in meetings as the representative of the v personnel and provides for healthful living condition of nursing personnel.5. Daily purposeful ward rounds to give insight to the problems and needs as presented by the patient and the family, nurses and other members of the health team. 6. Assists the Director of Nursing in the annual programming.7. Assumes the functions of the Director of Nursing delegated by the Medical Director and CQI Director in the absence of the latter.8. Plans and implements the nursing service, nursing audit or quality assurance.9. Serves as a Consultant in all Nursing Service Committee such as Quality Assurance, Grievance and Complaints Committee, Continuing Education Committee, and other related committees.10. Recommends to the Director of Nursing policies for the implementation of nursing care to provide quality, safe and relevant care.11. Helps maintain proper decorum among nursing personnel.12. Assess the training and in-service and continuing education needs of the nursing staff.13. Performs other duties as may be required by the Medical Director.

JOB DESCRIPTIONJob Title: Supervisor (Nurse III)

Job Summary:A mature registered nurse who is responsible for the coordination, supervision and delivery of quality nursing care of the whole hospital on the particular shift.He/She is accountable to the Director of Nursing for the management of the units under care.

Qualifications:a. Must be a graduate of an accredited school or College of Nursingb. Must be currently licensed in the Philippines.c. Possess a degree of Bachelor of Science in Nursing with at least CAR in Master of Arts in Nursing.d. Must have at least 2 years as staff nurse, 5 years as clinical managerial position experience, 1 year of which had been in the supervisory position in a general service in which administrative ability has been demonstrated.e. Must possess above average knowledge and skills in her area of specialty, as well as in general nursing.f. Be a member of good standing of the accredited professional organization of nurses. g. Must be in good physical and mental health.h. Must possess excellent leadership qualities and the capacity to communicate effectively in both oral and written form.i. Must be discreet and fair at all times.Trainings, seminars and workshops attendedTraining needs

Basic Nursing Programs, decentralized Programs,Specialty Program, Leadership Training, Communication And Critical Thinking,Progressive Clinical Nursing Program, Postgraduate Courses programs

j. Must know the principles of management and administration and be able to apply them accordingly.k. Must have BLS training in any institution in the country.l. Must be a licensed IV therapy preceptor.

Duties and ResponsibilitiesAssumes responsibility in the management of nursing care and services in the different areas of the hospital.

1. Assess, plans, implements and evaluates in cooperation with the headnurse, the various nursing activities and requirements in a unit.2. Make s regular rounds in the area of assignment, taking note of the needs and problems; offers advice and suggests solutions to such problems.3. Maintain a collaborative relationship with other supervisors to make sure that the nursing service runs smoothly.4. Makes the schedule of designated nursing personnel.5. Assumes the role of Director of Nursing when requested or in the absence of the latter.6. Ensures an effective endorsement of all duties and required information during shift change.7. Maintains a personal contact with all patients through ward rounds, conversation and teaching sessions.8. Monitors the standard of cleanliness in the ward areas, acts as liaison with the headnurse regarding cleaning problems and schedules.9. Reports any sickness or absenteeism to the Director of Nursing according to the appropriate procedure.10. Participates in the in service program of the nursing department; and keeps himself up to date on professional matters by attending lectures and reading appropriate journals.11. Undertakes the orientation of the new employees.12. Promotes and maintains good interpersonal and interdepartmental relationships.13. Monitors staffing levels in each ward; recommends duty changes accordingly.14. Acts as counselor to the nursing staff.15. Assists the headnurse in planning assignment of duties to nursing and auxiliary personnel.16. Recommends to the Director of Nursing deserving personnel for promotion as well as demotion, and helps in the performance evaluation of the nursing staff.17. Attends unit meetings and general nursing staff meetings18. Undertakes any other duties which may be required by the Director of Nursing or Director of the Hospital.19. Supervision of Patient Care Checks the Head Nurse plans for patient care and sees to it that they are properly executed. Keeps herself informed of patients needs and problems. Serves as consultant and adviser to the Senior Nurse in developing, devising and adopting work techniques and methods for the solution of problems related to patient care.20. Personnel Management Interprets standard operating and new procedures and policies, reviews work performance of personnel to determine if it conforms to recognize standards. Plans the programs and work of all the nursing personnel of the unit. Directs arrangements of schedule of work hours, off-duties, vacation leaves, etc., of all nursing person assigned in the unit. Evaluates work accomplished by each nursing employee in the ward. Prepares the plans for counseling of co-workers; this is done individually especially to personnel with problems Example: Habitual absenteeism and alcoholism Renders harmonious relationships and self-discipline among nursing personnel under her supervision. Helps in providing an adequate and safe environment by guiding and helping Head Nurses in providing and maintaining a safe, orderly and clean environment for patient and personnel.21. Ensure in providing adequate supplies and equipment by: Determining the needs for supplies and equipment based upon past experience and future plans for programs of patient care; Making proper representation to the administration of the needs of the department; Coordinating with the specially department (maintenance and property) to meet the needs for supplies and equipment for the department.

EMERGENCY ROOM NURSE SUPERVISOR

Duties and Responsibilities1. Supervision of patient carea. Check the Head Nurse schedule of operations.b. Ensures that the care/assistance given to the patients and doctors are executed properly and correctly. Keeps self informed of patients and doctors needs and problems Reinforces instructions given to patients and their families as needed. Verifies doctors order, requests and referrals to assure safe and effective care. Serves as consultant to the ER Head Nurse in developing, devising and adopting work techniques and methods for the solutions to the problems related to patient care.

2. Personnel Managementa. Interprets standards policies and procedures that governs operations of the area.b. Plans the programs and work of all the nursing personnel of the unit.c. Directs the arrangements of the schedule of works hours off-duties, vacation leaves, etc of all nursing personnel assigned in the ER.d. Conducts the evaluation of the work performance of each nursing personnel in the units.e. Prepares the counseling sessions of the personnel especially with personal or interpersonal problems.f. Provides a harmonious working relationships and self-discipline among nursing personnel under his supervision.

3. Assists Head Nurse in providing and maintaining a safe, orderly and clean environment for patient and personnel.

4. Ensures the provision of adequate supplies and equipment through:a. Anticipating the supplies and equipment needed for patient care.b. Communicates to the administration the needs of the unit.c. Coordinates with other areas to meet the needs for supplies and equipments of the area.

5. Takes responsibility for personal and professional growtha. Strives towards higher level of educational attainment.b. Attends seminars/conferences related to the profession.c. Encourages staff attendance in professional meetings.d. Devices programs to enhance staff expertise.e. Joins the recognized and accredited organizations of the profession.f. Participates in researches related to the profession

OPERATING ROOM NURSE SUPERVISOR

Duties and Responsibilities1. Supervision of patient carea. Check the Head Nurse schedule of operations.b. Ensures that the care/assistance given to the patients and doctors are executed properly and correctly. Keeps self informed of patients and doctors needs and problems Reinforces instructions given to patients and their families as needed. Verifies doctors order, requests and referrals to assure safe and effective care. Serves as consultant to the OR Head Nurse in developing, devising and adopting work techniques and methods for the solutions to the problems related to patient care.

2. Personnel Managementa. Interprets standards policies and procedures that governs operations of the area.b. Plans the programs and work of all the nursing personnel of the unit.c. Directs the arrangements of the schedule of works hours off-duties, vacation leaves, etc of all nursing personnel assigned in the OR.d. Conducts the evaluation of the work performance of each nursing personnel in the units.e. Prepares the counseling sessions of the personnel especially with personal or interpersonal problems.f. Provides a harmonious working relationships and self-discipline among nursing personnel under his supervision.



5. Takes responsibility for personal and professional growtha. Strives towards higher level of educational attainment.b. Attends seminars/conferences related to the profession.c. Encourages staff attendance in professional meetings.d. Devices programs to enhance staff expertise.e. Joins the recognized and accredited organizations of the profession.f. Participates in researches related to the profession.

DR/ NURSERY SUPERVISOR

Duties and Responsibilities1. Supervision of patient carea. Check the Head Nurse schedule of deliveries.b. Ensures that the care/assistance given to the patients and doctors are executed properly and correctly. Keeps self informed of patients and doctors needs and problems Reinforces instructions given to patients and their families as needed. Verifies doctors order, requests and referrals to assure safe and effective care. Serves as consultant to the DR/Nursery Head Nurse in developing, devising and adopting work techniques and methods for the solutions to the problems related to patient care.

2. Personnel Managementa. Interprets standards policies and procedures that govern operations of the area.b. Plans the programs and work of all the nursing personnel of the unit.c. Directs the arrangements of the schedule of works hours off-duties, vacation leaves, etc of all nursing personnel assigned in the DR/Nursery.d. Conducts the evaluation of the work performance of each nursing personnel in the units.e. Prepares the counseling sessions of the personnel especially with personal or interpersonal problems.f. Provides a harmonious working relationships and self-discipline among nursing personnel under his supervision.



5. Takes responsibility for personal and professional growtha. Strives towards higher level of educational attainment.b. Attends seminars/conferences related to the profession.c. Encourages staff attendance in professional meetings.d. Devices programs to enhance staff expertise.e. Joins the recognized and accredited organizations of the profession.f. Participates in researches related to the profession.6. Coordinator Newborn Screeninga. Follow-up results and informs parents for any abnormalities.b. Request NBS filters.c. Facilitate payments for NBS.

ICU NURSE SUPERVISOR

Duties and Responsibilities1. Supervision of patient carea. Check the Head Nurse schedule of operations.b. Ensures that the care/assistance given to the patients and doctors are executed properly and correctly. Keeps self informed of patients and doctors needs and problems. Reinforces instructions given to patients and their families as needed. Verifies doctors order, requests and referrals to assure safe and effective care. Serves as consultant to the ICU Head Nurse in developing, devising and adopting work techniques and methods for the solutions to the problems related to patient care.

2. Personnel Managementa. Interprets standards policies and procedures that governs operations of the area.b. Plans the programs and work of all the nursing personnel of the unit.c. Directs the arrangements of the schedule of works hours off-duties, vacation leaves, etc of all nursing personnel assigned in the ICU.d. Conducts the evaluation of the work performance of each nursing personnel in the units.e. Prepares the counseling sessions of the personnel especially with personal or interpersonal problems.f. Provides a harmonious working relationships and self-discipline among nursing personnel under his supervision.



5. Takes responsibility for personal and professional growtha. Strives towards higher level of educational attainment.b. Attends seminars/conferences related to the profession.c. Encourages staff attendance in professional meetings.d. Devices programs to enhance staff expertise.e. Joins the recognized and accredited organizations of the profession.f. Participates in researches related to the profession.

JOB DESCRIPTIONJob Title: Head Nurse (Nurse II)

Job Summary:A registered nurse who is responsible for the organization, management, and implementation of a program of nursing care for each patient in a unit or a special area. She is responsible for the unit on a 24-hour basis. The head nurse is accountable to the supervisor.

Qualificationsa. A graduate of an accredited school of College of Nursing.b. Currently a registered Nurse in the Philippinesc. Possess a degree of Bachelor of Science in Nursing with at least 18 units in Master of Arts in Nursing.d. Must have at least 2 years as staff nurse, 3 years as clinical managerial position experience in a general service in which administrative ability has been demonstrated.e. Must be a member of accredited national organization for nurses.f. Must have good leadership traits, as well as good interpersonal relationship with co-workers.g. Must have the ability to apply sound judgment and put to practice principles of administration.h. Must be mentally and physically fit.i. Must have the ability to communicate effectively in oral and written form.j. Must have above average knowledge and skills in her area of nursing specialty as well as general nursing.k. Must have BLS training in any institution in the country.l. Must be a licensed IV therapy preceptor.Trainings, seminars and workshops attendedTraining needs

Basic Nursing Programs, Decentralized Programs, Specialty ProgramLeadership Training, Communication And Critical Thinking,Progressive Clinical Nursing Program

Duties and Responsibilities1. Manages and supervises all nursing care given to patients in the unit.2. Guides, teaches and evaluates staff nurses, nursing attendants and orderlies.3. Makes regular rounds to all patients assessing and evaluating their case as required.4. Makes schedule of the nursing staff in the unit and submits it to the supervisor and the Nursing Director for approval.5. Assists with coordination of tasks between the medical, nursing staff, patients and relatives.6. Is fully conversant with policies, SOPs guidelines of the hospital and nursing service.7. Applies knowledge of nursing principles and skills and exercises judgment in the delegation of tasks to the members of the nursing team.8. Acts as supervisor when designated.9. Assists in the orientation of new personnel in the area.10. Collaborates with the other nurses to make certain that patient care runs smoothly.11. Gives direct nursing care in certain situations as well as in the absence of the staff nurse.12. Transcribes doctors orders in the patients record file and sees to it that they are promptly carried out.13. Acts as a nursing consultant and counselor to her staff.14. Is responsible for requesting for and maintaining equipment and supplies in the ward.15. Makes rounds with doctors whenever free from her managerial role.16. Undertakes the performance evaluation of her nursing staff every month. 17. Receives proper endorsement from outgoing staffs/ incoming staffs.18. Bedside rounds after endorsement and thereafter.19. Interacting with folks and patients by giving health advice and concerns.20. Answer code calls.21. Answer / responds to calls of Resident/s or other personnel that the staff cannot response soon.22. Reminds staffs/orderly of oxygen standby at beside to pull-out and charge after.23. Counter check the completeness of patients charts.24. Monitor the Admission/ Discharge/ Absences patient/s at the unit.25. Check the completeness of discharge patient chart before forwarding to Record Station.26. Reminds staff to start soon the availablemeds of patient/s especially the anti-biotic drugs.

JOB DESCRIPTIONJob Title: Staff Nurse (Nurse I)

Job SummaryA registered nurse who assists the head nurse in planning, directing, and coordinating the nursing care of the patients in a unit.Undertakes direct nursing care to patients with the assistance of other members of the health team.

QualificationsNameAcademic QualificationWork experiencesTrainings, seminars and workshops attendedTraining needs

Nurse APosition: Staff NurseRegistered NurseHave 9 units in Master of Arts in Nursing Major in Nursing Service Administration2 years and 5 months staff nurseBasic Nursing Programs, Decentralized Programs,Specialty Program,

Leadership Training, Communication And Critical Thinking, Progressive Clinical Nursing Program

Nurse BPosition: Staff NurseRegistered Nurse1 year and 5 months staff nurseBasic Nursing Programs, Decentralized Programs,

Specialty Program,Leadership Training, Communication And Critical Thinking, Progressive Clinical Nursing Program

Nurse CPosition: Staff NurseRegistered Nurse1 year and 5 months staff nurseBasic Nursing Programs, Decentralized Programs,

Specialty Program,Leadership Training, Communication And Critical Thinking, Progressive Clinical Nursing Program

Duties and Responsibilities

1. Prepares, administers, and charts accurately medications and treatments given to patients at the patients record file.2. Plans and gives direct nursing care to patients and evaluates their care.3. Encodes truthful information about the patients status on the patients record file and on patients accounts.4. Supervises nursing aides as they assists in the care of the patients.5. Assists the head nurse in planning for the care of the patients.6. Acts as charge nurse when designated.7. Attends meetings and conferences.8. Is fully conversant with the hospital policies and regulations, SOPs and keeps up-to-date with such matters.9. Observes and ensures that nursing care is carried out in accordance with Doctors instructions.10. Observes records and reports to head nurse and/or doctor the patients conditions, reaction to drugs and treatment as well as other significant incidents.11. Brings to the attention of the head nurse the shortage of supplies and the existence of potentially hazardous or faulty equipment.12. Charts accurately nursing observations and changes in patients condition.13. Regularly attends and actively participates in the in-service program of the nursing department14. Prepares patient and equipment required; assists in the examination of patients.15. Safeguards hospital equipment and ensures the economical use of supplies.16. Applies knowledge of nursing principles and skills, exercises judgment in the delegation of duties to the other members of the health team.17. Gives health teachings to patient and family.18. Knows each patient in the ward his diagnosis, treatment, condition and other social problems.19. Helps patients and their families with their problems by referrals, advice or sympathetic listening.20. Assists the head nurse in evaluating the performance of other staff.21. Establishes and maintains good interpersonal and intradepartmental relationships.22. Forwards to the billing section the oxygen meter readings and other charges incurred by the patient.23. Sends charts of patients with discharge orders to the billing section for assessment of the hospital bill.24. Forwards charts of discharged patients to the record section and after having checked the chart as to its completeness and chart arrangements.25. Discharges patient.26. Performs post mortem care.

OPERATING ROOM STAFF NURSE

Duties and Responsibilities1. Nursinga. Prepares operating room for surgery.b. Identifies and assess patients condition.c. Assists and circulates in operations and procedures.

2. Reporting and recordinga. Writes the account of procedure, treatments and medications given to the patient accurately.b. Makes accurate report/record of the instruments, sponges and needles used to the patient.c. Accomplishes inventories of equipment, instruments and linen supplies.d. Updates administrative and clinical records.e. Accounts for all linens and gowns during her shift and endorses them to the next shift.

3. Scrub nursea. Prepares instruments, supplies, equipment to be used in a particular operation or procedure.b. Prepares the drapes, opens the sterile packs and arranges them accordingly.c. Assists the surgeons during the operation from draping of the patient to the handling of instruments and supplies and final care of the patient.d. Maintains sterility of the instruments and supplies of the operative field.e. Performs after care of the operating room and the instruments.f. Collaborates with the circulating nurse in the accurate counting of instruments, sponges and needles.g. Preserves and labels specimen for laboratory examination and legal purposes correctly.

4. Circulating nursea. Receives patient from ward room, takes vital signs, name of patient, name of operation, intravenous fluid(s), medications administered and doctors orders.b. Prepares operative area by sterilization of the skin and draping.c. Positions patient for the desired operation.d. Observes the progress if surgery, providing additional instruments, supplies and other items needed.e. Performs accurate counting of instruments, sponges and needles before the start of operation and before closure of incision. f. Makes a complete assessment and care of the patients recovery.g. Assist and collaborates with the anesthesiologist in providing medication to the patient during the stay in the operating room.

5. Special procedure nursea. Acts as a regular operating room nurse with similar responsibilities. Furthermore, he/she is required to assist/scrub or circulate in special procedure like laparoscopy or arthroscopy.b. He/she is in charge with the safe keeping of instruments of special procedures and can seek assistance from other OR nurses or OR technician.c. He/she is in charge with the after care of the laparoscopic instruments and machines.d. Make reports of any damage to laparoscopic hand instruments (this includes trocars, fiber optic cables and scopes) or machine.e. Responsible for completeness of supplies or needed materials before the said operation.

RECOVERY ROOM STAFF NURSE

Duties and Responsibilities1. Make the following initial observations:a. Time of arrival to the unit.b. Responsiveness (to what the patient responds and how he/she responds)c. Vital signs and other initial vital parameters as indicated in the monitoring sheet. Temperature Pulse Respiration Blood pressure CVP MIOs etcd. Skin Color Temperature (warmth or coolness) Condition (dryness or moisture)e. Dressing Clean, dry and intactf. Look and feel under patient to detect pooling of bloodg. Presence of an intravenous infusion Type of solution Amount left in the bottle Drip rateh. Presence of urinary bladder catheter Clamped or unclamped Connected to drainage bag or bottle Freely draining Characteristics and amount of urinei. Presence of other drainage tubes Clamped or unclamped Attach appropriately to bottle or suction Tubes not kinked or under patient Characteristics and amount of drainagej. Safety and comfort Presence of pain, nausea or vomiting Position appropriately for surgical procedure Side rails up, bed in low position and call light within reach

2. Check the chart for the following information (some of which may have been included in the report from the OR nurse)a. Surgical procedure or length of surgeryb. Postoperative diagnosisc. Anesthetic agents or length of anesthesiad. Estimated blood losse. Blood or fluid replacement given during surgery and RR stayf. Type and location of drainsg. Vital signs when patient left RR (for use as baseline)h. Medication administered in the RR: Time Type Amount Response of the patienti. Output Urine Other drainage Vomitusj. Physicians orders Frequency of vital signs Diet Activity Intravenous orders Medication (amount and frequency of pain and other medication used) Laboratory or respiratory therapy orders Other specific to type of surgery and other problems of patients

NEONATAL ICU STAFF NURSE

Duties and Responsibilities1. Patient care management

The staff nurse shall initiate and perform nursing care services to meet the needs of born well and sick infants in NICU utilizing the nursing process.

a. Directs patient care provided by support personnel for a specific shift.b. Identifies changes in patients physiological condition.c. Coordinates patients status to multidisciplinary team members.d. Communicates directly with patients family about nursing care.e. Provides clinical intervention to meet the patients needs. Routine newborn care on admission Cord dressing Giving eye prophylaxis Giving vitamin K and hepatitis B immunization to the newborn Getting the anthropometric measurement such as the head, chest, and abdominal circumferences, the birth weight and length Taking the vital signs. Monitoring the patients intake and output Giving medications (IV, oral, IM) Feeding the patients orally by cup/dropper and tube (nasopharyngeal and oropharyngeal) Suctioning when necessary Turning the patient every two hours especially those on phototherapy exposure with eye and gonadal shields Initiating access (with IV therapy nurse) Assess in the laboratory works (e.g. drawing blood for CRP and ABGs) Performs ambubagging/thumb bagging with mechanical ventilator apparatus (CPAP) Monitoring glucose level of the patientf. Documents nursing process.g. Assimilates information from multiple sources and implements appropriate action plan to provide safe quality care.h. Assures safety and security of the patients.i. Conducts discharge planning with patients family.j. Implements strict breastfeeding regulation through encouraging mothers to breastfeed/room-in their babies.k. Facilitate in taking newborn screening test.

2. Hospital and nursing service policies and regulation.a. Observe hospital and nursing service rules, regulations and policies.3. Professional responsibilitiesa. Takes initiative and responsibility for memberships in professional organization and participates actively in their programs and activities.b. Keeps self professionally update through continuing education.c. Updates professional license.

EMERGENCY ROOM STAFF NURSE

Duties and Responsibilities1. Assess and Admits out or in patient.2. Performs routine assessment such as vital signs (BP, PR, RR, Temp) and fetal heartbeat (FHB).3. Carry out physicians order.4. Monitor Patients Progress.5. Assist physician during internal examination, and other Procedure needed.6. Assist/carry out laboratory works and other Diagnostic Tests.7. Administer medications (per orem, sublingual, subcutaneous, IM and IV) as ordered.8. Perform proper documentation (e.g. nurses notes, intake and output, carry out physicians order, etc)9. Transfer out patient to their room of choice with doctors order.10. Endorsed properly to the ward/ ICU/ OR/ DR/ LR nurse.

TRAUMA CASES1. Assist patient in position.2. Perform preparation needed for procedure.3. Assist the doctor in gowning.4. Perform responsibilities of a circulating nurse such as providing materials or equipment needed by the physician.5. Assist the patient during procedure if with permission of the physician.6. Documenting important information.7. Administer medications (e.g. IM and IV) as ordered.8. Performs assessment such as vital signs (BP, PR, RR, Temp) Assist patient in transferring to the stretcher and bring to Room of choice.

1. Check uterus if well contracted and massage as needed.2. Check episiotomy site and diaper for excessive blood discharges and refer accordingly.3. Perform proper documentation (e.g. nurses notes, intake and output, carry out physicians order, etc)4. Transfer out patient to their room of choice with doctors order.5. Endorsed properly to the ward nurse.

DR/NURSERY STAFF NURSE

Duties and ResponsibilitiesPREPARTUM11. Admits prepartum patients in the labor.12. Performs routine assessment such as vital signs (BP, PR, RR, Temp) and fetal heartbeat (FHB).13. Carry out physicians order.14. Monitor progress of labor.15. Assist physician during internal examination, artificial rupture of membrane, catheterization, IV insertion, induction of epidural anesthesia16. Do perineal shaving and flushing prior to delivery.17. Assist/carry out laboratory works (e.g. CBC, bloodtyping, HBsAg screening, urinalysis, etc)18. Administer medications (per orem, sublingual, subcutaneous, IM and IV) as ordered.19. Give health teachings regarding breastfeeding and room-in policy of the hospital.

ANTEPARTUM9. Assist patient in lithotomy position.10. Perform perineal preparation and perineal shaving if not yet done in the labor room.11. Assist the doctor and midwife in gowning.12. Perform responsibilities of a circulating nurse such as providing materials or equipment needed by the physician.13. Assist the patient during delivery such as coaching her to bear down or doing fundal push if with permission of the physician.14. Documenting important information such as time of delivery, time of placenta expulsion and time of episiotomy.15. Administer medications (e.g. IM and IV) as ordered.16. Check blood pressure right after the placenta was expelled completely.17. Provide ice pack over hypogastrium and massage for a firm and well contracted uterus.18. Clean the patients nipples for latching on the baby.19. Performs final perineal flushing.20. Provide diapers.21. Assist patient in supine position.22. Assist patient in transferring to the stretcher and bring to labor room for postpartum monitoring.

POSTPARTUM6. Performs assessment such as vital signs (BP, PR, RR, Temp) usually every 15 minutes for two hours until stable or depending on the doctors order.7. Check uterus if well contracted and massage as needed.8. Check episiotomy site and diaper for excessive blood discharges and refer accordingly.9. Perform proper documentation (e.g. nurses notes, intake and output, carry out physicians order, etc)10. Transfer out patient to their room of choice with doctors order.11. Endorsed properly to the ward nurse.

ICU STAFF NURSE

Duties and Responsibilities1. Receives the written orders from the Emergency Room and/or Operating Room and special instructions about patients care and caries them out accurately.2. Explain set-up, ICU care and post-operative care (monitoring, intubations, lines, catheter, dressing and drains) and expected possible outcomes.3. Evaluate, note, observe, ascertain specified documentation of patients clinical manifestation including temperature, pulse, depth of respiration, quality of breathing, blood pressure, state of consciousness, eye opening, verbal response and ability to follow commands, essential to assess whether the patients condition is improving, worsening or unchanged, and report immediately any condition and deviation in the neurologic function.4. Provide comfort and maintain safety. Providing the patient a quiet, comfortable and planned periods of rest is possible.5. When the patient is fully awake, encourage deep breathing exercises to prevent pneumonia.6. Facilitate frequent turning and repositioning as necessary to prevent contractures, decubitus ulcers, urinary stasis, atelectasis, pneumonia, and other pulmonary complications.7. Maintain accurate intake and output record and be aware of the significance of any alarming and peculiar signs and symptoms and report at once.8. Administer medication and carry out treatment and procedures and note down the reactions.9. Inspects dressing from time to time to detect signs of undue hemorrhage of frank bleeding.10. Perform external cardiac massage (CPR) in case the patient goes on cardiac or respiratory arrest and administer drugs as directed.11. Provide continued assessment of the patients level of consciousness/responsiveness by maintaining a neurologic observation record.12. Observe, evaluate and carry out repeated clinical examinations to determine hour-to-hour changes in patients status.13. Do hemodynamic monitoring for clinically ill patients like CVP reading, ECG tracing and cardiac monitoring, etc.14. Frequently observe and evaluate the patient for any sign that may indicate the onset of complications like evaluation in temperature, blood pressure, swelling and bleeding.15. Explain to the folks and family the reason for hospitalization, diagnostic test and other therapies to be administered.16. Give NGT feeding if the patient is unable to swallow and prevent aspiration and ensure adequate respiratory ventilation.17. Go with the doctors rounds without fail to clarify and carry out orders accurately.18. Attach any drainage apparatus when drainage is to be collected in a bottle from cholecystectomy tube, indwelling catheters and chest tubes.19. Give tracheostomy, colostomy care and change dressing if necessary.20. Suction tracheostomy and endotracheal tube to remove secretions that have accumulated in the tracheobronchial tree and do correct back/chest tapping procedure.21. Assist the physician in endotracheal intubation and other related ventilator procedures like administer oxygen, ambubagging, VR, T-piece.22. Check IV site for leakage and tissue infiltration and change site/dressing if necessary.23. Provide adequate psychological support for the patient.

JOB DESCRIPTIONJob Title: Midwife

Job SummaryA certified midwife who provides basic patient care under direction of a DR/Nursery head nurse. She also works closely with nurses and medical staff to ensure that a patient is provided basic care on a daily basis. Perform duties, such as feed, bathe, dress, groom, or move patients, or change linens.

Qualificationsa. A graduate of an accredited or certified midwifery schools.b. Must have at least 2 years experience in general wards.c. Physically and mentally healthy.d. Neat and clean in appearance, with pleasing personality.e. Possessing thorough knowledge of nursing principles and procedure; committed to quality care.f. Able to work well with medical and paramedical personnel.g. Possessing leadership skills and good communication skills.h. Diligent, resourceful, and loyal; able to hold matters pertaining to patients and co-workers personal affairs in strict confidentiality.

Duties and ResponsibilitiesPREPARTUM1. Monitor the progress of uterine contractions, its interval, duration and frequency.2. Assist the doctor and patient when performing internal examination.3. Monitor patients vital signs.4. Assist in normal spontaneous delivery.5. Responsible for cleaning up the Delivery Room after delivery and making sure the proper disposal of blood and placenta.6. Change beddings at the labor room and dispersing soiled linens in the delivery room and labor room to the laundry department.7. Encoding all charges of the patient.8. Follow up replacement from CSR and pharmacy (medicines, supplies used by the patient).

ROUTINE RESPONSIBILITIES1. Inventory of OB pack, baby care set, instruments, supplies and taking into consideration its expiration date.2. Packing of used instruments and sending them to the central sterile room for autoclaving.3. Check the availability of instruments at DR.4. Refill respective canisters with gauze, cherries, cotton balls, and gloves.5. Cleaning and mopping every shift if no attendant is on duty.6. Inventory of linens in the delivery room.7. Helps the nurses in taking care of babies in the nursery if there is no prepartum.8. Assist mothers while breastfeeding by giving more encouragement and instruction on how to do proper positioning of baby and proper techniques.

JOB DESCRIPTIONJob Title: Nursing Aide

Job SummaryA certified nurse aide who provides basic patient care under direction of a head nurse. A certified nurse aid also works closely with nurses and medical staff to ensure that a patient is provided basic care on a daily basis. Perform duties, such as feed, bathe, dress, groom, or move patients, or change linens.

Qualifications

NameAcademic QualificationWork experiencesTrainings, seminars and workshops attendedTraining needs

Health aid APosition: Nursing AttendantCertified Nursing Assistants (CNAs)Certified Medication Assistant (CMA)2 year experience unit assigned.

Basic Cardiac Life Support- Healthcare Provider (BCLS-HCP),Basic computer orientation and simulationInterpersonal Communication Skills Program

Health aid BPosition: Nursing AttendantCertified Nursing Assistants (CNAs)Certified Medication Assistant (CMA)1 year experience unit assigned.

Basic Cardiac Life Support- Healthcare Provider (BCLS-HCP)Interpersonal Communication Skills Program,Basic Computer orientation and simulation

Health aid CPosition: Nursing AttendantCertified Nursing Assistants (CNAs)

1 year experience unit assigned.

Basic Cardiac Life Support- Healthcare Provider (BCLS-HCP)Interpersonal Communication Skills ProgramBasic Computer orientation and simulation


1. Turn and re-position bedridden patients, alone or with assistance, to prevent bedsores.2. Answer patients' call signals.3. Feed patients who are unable to feed themselves.4. Observe patients' conditions, measuring and recording food and liquid intake and output and vital signs, and report changes to professional staff.5. Provide patient care by supplying and emptying bed pans, applying dressings and supervising exercise routines.6. Provide patients with help walking, exercising, and moving in and out of bed.7. Bathe, groom, shave, dress, and/or drape patients to prepare them for surgery, treatment, or examination.8. Collect specimens such as urine, feces, or sputum.9. Prepare, serve, and collect food trays.10. Clean rooms and change linens.11. Transport patients to treatment units, using a wheelchair or stretcher.12. Deliver messages, documents and specimens.13. Answer phones and direct visitors.14. Administer medications and treatments, such as catheterizations, suppositories, irrigations, enemas, massages, and douches, as directed by a physician or nurse.15. Restrain patients if necessary.16. Maintain inventory by storing, preparing, sterilizing, and issuing supplies such as dressing packs and treatment trays.17. Explain medical instructions to patients and family members.18. Perform clerical duties such as processing documents and scheduling appointments.19. Work as part of a medical team that examines and treats clinic outpatients.20. Set up equipment such as oxygen tents, portable x-ray machines, and overhead irrigation bottles.21. Collects urine and fecal specimen and takes them to the laboratory.22. Keeps an accurate record of patients intake and output.23. Answers call bells and relays messages24. Assists staff nurse in the care of the confused and unmanageable patients.25. Gives, empties, and keeps clean bedpans, and urinals.26. Obtains necessary supplies and equipments from the Central Supply and exercises responsibility over them27. Safeguards equipment of the unit and assists in their inventory.28. Performs simple nursing care and treatment for patients like enema, skin prep, and sponge bath.29. Helps in maintaining order and cleanliness in the nurses station, treatment and utility room30. Assists in post mortem care and transport of dead body to the morgue31. Does janitorial duties when necessary.

JOB DESCRIPTIONJob Title: Orderly

Job SummaryAn auxiliary worker who works under the supervision of the head nurse and the supervisor. He performs various cleaning and janitorial chores in areas assigned to him.

Qualifications

a. Completion of the high school course.b. Ability to read, write, and interpret verbal or written instructions.c. Physically and mentally fit.d. Diligent, courteous, and trustworthy.e. Able to adjust well to changes in areas of assignment.


1. Escorts newly admitted patients to the room or ward. Assist the patient to his/her bed.2. Transports patients from one area to another by wheelchair or stretcher.3. Reports any defective equipment to head nurse or supervisor.4. Furnishes patients with oxygen tank, gauge and regulator.5. Records and charge oxygen consumed by the patient.6. Ensures that the oxygen cylinder stock level is maintained in the ward at all times.7. Does janitorial job when necessary.

JOB DESCRIPTIONJob Title: Utility worker

Job Summary

An auxiliary worker who works under the supervision of the head nurse and the supervisor. He performs various cleaning and janitorial chores in areas assigned to him.

Qualifications

a. Completion of the high school course.b. Ability to read, write, and interpret verbal or written instructions.c. Physically and mentally fit.d. Diligent, courteous, and trustworthy.e. Able to adjust well to changes in areas of assignment.


1. Perform any combination of light and heavy cleaning duties to maintain the hospital in a clean and orderly manner.2. Does janitorial job.3. Cleans and disinfect room, hallways, lobbies, lounges, restrooms, corridors, elevators, stairways, locker room, and other work areas so that health standards are met.4. Empty trash and waste to disposal areas.5. Segregate and dispose waste properly.6. Reports any defective equipment to head nurse or supervisor.

STAFFING

(*Adopted from the Hospital Nursing Service Administration Manual of the Department of Health)

This is a one hundred (100) bed capacity tertiary hospital. 30% of patients need minimal care, 45% of patients need moderate care, 15% of patients need intensive care, and 10% of patients need highly specialized care.

Percentage of Patients in Various Levels of Care(100 Bed Capacity)

Type of CarePercentage of Patients (%)Number of Patients

Minimal Care30105

Moderate Care45157.5

Intensive Care1552.5

Highly Specialized Care1035

STAFFING FORMULA

Find the number of nursing personnel needed for 350 patients in Divine Mercy Medical Center.1. Categorize the patients according to levels of care needed.100 x 0.30 = 30 patients needing minimal care100 x 0.45 = 45 patients needing moderate care100 x 0.15 = 15 patients needing intensive care100 x 0.10 = 10 patients needing highly specialized care2. Find the number of Nursing Care Hours (NCH) needed by patients at each level of care per day30 pts x 1.5 (NCH needed at Level I) = 45 NCH/day45 pts x 3 (NCH needed at Level II) = 135 NCH/day15 pts x 4.5 (NCH needed at Level III) = 67.5 NCH/day10 pts x 6 (NCH needed at Level IV) = 60 NCH/day TOTAL = 307.5 NCH/day3. Find the total NCH needed by 100 patients per year.307.5 NCH/day x 365 (days/year) = 112,237.5 NCH/year4. Find the actual working hours rendered by each nursing personnel per year.8 (hrs/day) x 213 (working days/year) = 1, 704 working hours/year

5. Find the total of nursing personnel needed.a. Total NCH per year divided by the working hours per year112,237.5 NCH/year 1, 704 working hours/year = 66 nursing personnelb. Relief x total nursing personnel66 nursing personnel x 0.15 = 10 relieversc. Total nursing personnel needed66 nursing personnel + 10 relievers = 76 total nursing personnel6. Categorize to professional and non-professional personnel. Ratio of professionals to non-professionals in a special tertiary hospital is 70:30.266 total nursing personnel x 0.65 (percentage of RN) = 49 Registered Nurses266 total nursing personnel x 0.35 (percentage of NA) = 27 Nursing Attendants7. Distribute by shifts. (The distribution usually followed is 45% for the morning shift, 37% for the afternoon shift and 18% for the night shift.)For Registered Nurses:A.M. shift:49 nurses x 0.45 = 22 nursesP.M. shift:49 nurses x 0.37 = 18 nursesNOC shift:49 nurses x 0.18 = 9 nursesTOTAL = 49 Registered NursesFor Nursing Attendants:A.M. shift:27 nurses x 0.45 = 12 nursing attendantsP.M. shift:27 nurses x 0.37= 10 nursing attendantsNOC shift:27 nurses x 0.18 = 5 nursing attendantsTOTAL = 27 Nursing AttendantsThis is the schedule of employees at the Divine Mercy Medical Center. The hospital is composed of 49 nurses and 27 nursing attendants. Of the 49 nurses, 22 are tasked for the morning shift, 18 for the afternoon shift, and 9 for the night shift. There are 27 nursing attendants to help the nurses. 12 are assigned in the morning, 10 in the afternoon, and 5 during nighttime. This staffing modality was adopted from the Hospital Nursing Service Administration Manual of the Department of Health. We used the 8 nursing care hours (NCH) per patient per day and a 65:35 professional to nonprofessional ratio that is applicable in a tertiary hospital. All of our staff nurses are registered nurses, thus they have all equal chances of success in the different units of the medical center. We used the decentralized type of scheduling which means that the head nurse of the unit is responsible in making the schedule. The staff nurses are responsible for choosing their off days also for their convenience. The schedule is good for only 30 days long and repeats thereon like a cycle.In our 30 days or 1 month schedule, nurses and attendants report for duty 5 days a week with the head nurse choice of shift. Only 2 days off are allowed per week and these are distributed over a week where the unit has no heavy needs. After 30 days, the schedule changes. Since not all of the staff could have a change in their shift after 30 days, an open communication between the head nurse and the subordinates is encouraged. Night shift nurses should take a 2 days off before reporting for the morning shift after 30 days. The head nurse and other senior nurses are encouraged to take the morning shift duty where the bulk of the units work is happening.Morning shift has more number of nursing personnel because most of the nursing procedures are done during this time. Since doctors rounds are also happening more during afternoon shift, there are also enough nursing personnel to man the unit. Night time is a shift to rest so the nursing personnel are also decreased but more enough to cover the other needs of the critical care patients. Furthermore, the unit assignment of the nursing personnel between the different units is identified during the change of shift. It is during this time where the number of mix personnel is distributed depending on the number of patients admitted and the load of the work for that day and shift.The Divine Mercy Medical Center also has 25 institutional workers (15 orderlies and 10 utilities) to aid in the physical operation and maintenance of the units. Everyday 5 orderlies and 3 utilities report for duty per shift. They also are given 2 off days per week and follow the same cyclical schedule as identified for the nursing personnel.

STAFFING PERSONNEL COMPUTATION FOR OPERATING ROOM

TWO (2) OPERATING ROOM BEDS = 8 HOUR SHIFTNURSE / PATIENT RATIO = 2 : 1

SHIFTSCRUBCIRCULATORTOTAL

AM224

PM224

NOC112

10

OFF DUTY STAFF = (10 X 110) / 262 = 4.19 ~ 4 Off-duty Nurse

Where 110 is constant 262 = 8hrs total working days/yr

TOTAL OPERATING ROOM PERSONNEL: TOTAL STAFF TO FUNCTION:

AM4

PM4

NOC2

OFF4

TOTAL14

10 + 4 = 14 (Regular Staff) + 1 (Endoscopy Nurse) + 1 (Head Nurse) + 4 (Relievers) 20

STAFFING PERSONNEL COMPUTATION FOR DELIVERY ROOM

TWO (2) DELIVERY ROOM = 8 HOUR SHIFTNURSE / PATIENT RATIO = 2 : 1

SHIFTASSISTBABY CARETOTAL

AM224

PM224

NOC112

10




AM4

PM4

NOC2

OFF4

TOTAL14

10 + 4 = 14 (Regular Staff) + 1 (Head Nurse) + 4 (Relievers) 19

STAFFING PERSONNEL COMPUTATION FOR EMERGENCY ROOM

FIVE (7) EMERGENCY ROOM BEDS = 8 HOUR SHIFTNURSE / PATIENT RATIO = 2 : 1

SHIFTMEDICINESURGERYOB/GYNPEDIATOTAL

AM11114

PM1113

NOC1113

10




AM4

PM3

NOC3

OFF4

TOTAL14


STAFFING PERSONNEL COMPUTATION FOR INTENSIVE CARE UNIT

SEVEN (7) BED = 8 HOUR SHIFT2 MICU, 1CCU, 2 SICU, 2 PICUNURSE / PATIENT RATIO = 2 : 1

SHIFTICUCCUSICUPICUTOTAL

AM11114

PM1113

NOC1113

10




AM4

PM3

NOC3

OFF4

TOTAL14


NURSING SERVICE POLICIES

When does the institution hire employees?

When there is a need to cover the vacant jobs for the smooth-sailing operation of the hospital and the different units. Usually a new employee is selected or appointed within six (6) months after a certain vacant item has been posted.

Documents to be submitted

Application letter addressed to the Chief Nurse Comprehensive resume with 1 pc. 2x2 ID picture with white background Authenticated copy of college diploma Authenticated copy of transcript of records NBI Clearance Police Clearance Certificate of Passing/Board Certificate (from PRC) Professional ID card (PRC licenses for all professionals) Updated IV Therapy ID (for all nurses) Updated PNA card (for all nurses) Certification letter from the Dean Certificates earned for the past 3 years which should include their latest (current year): BLS Training Certificate (for all nurses) ACLS Certificate (for nurses) for special area Other training and seminar certificates

NURSING SERVICE POLICIES

A. Employment Policy1. An applicant shall be required to write a letter of application which shall be supported by a bio data, transcript of records, Diploma, Board Rating result, and NBI Clearance. They also need to pass their latest IV Therapy, Basic Computer Training, BLS and ACLS certificate (if any) and their PRC ID.2. An initial interview shall be scheduled and conducted by the hospital Selection and Promotions Com

NSO

Documents

Transcript of NSO