R E S T R I C T E D - Army · REPUBLIC OF THE PHILIPPINES DEPARTMENT OF NATIONAL DEFENSE ... 8-2 Scope of Professional Nursing Practice (R.A No. 7164 “Philippine Nursing Act of

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REPUBLIC OF THE PHILIPPINES DEPARTMENT OF NATIONAL DEFENSE

CHIEF OF STAFF ARMED FORCES OF THE PHILIPPINES

CAMP GENERAL EMILIO AGUINALDO, QUEZON CITY

15 August 2001

SUBJECT: Authority to Promulgate TO: All Concerned

1. The PHILIPPINE ARMY NURSING SERVICE ADMINISTRATION MANUAL (PAM) 1-05 was formulated/revised by the OFFICE OF THE ARMY CHIEF NURSE assisted by the OFFICE OF THE DOCTRINE CENTER, TRADOC, PA.

2. The Commanding General, Philippine Army recommends

approval for the promulgation of this manual. 3. The promulgation of the PHILIPPINE ARMY NURSING

SERVICE ADMINISTRATION MANUAL MAY 2001 by the Philippine Army is hereby approved effective this date.

BY ORDER OF SECRETARY OF NATIONAL DEFENSE:

DIOMEDIO P VILLANUEVA General AFP

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COMMANDING GENERAL PHILIPPINE ARMY

Fort Andres Bonifacio, Metro Manila

FOREWORD

The modernization of the Philippine Army is centered on the acquisition of high-tech equipment and weaponry and also, in the upgrading of technical skills, management policies, and ethical standards. Among the areas affecting our nursing service personnel are those involving skills development, information technology and management systems. It is therefore very appropriate that the Philippine Army Nursing Service takes bold steps in seeking improvement in its role as it continuously reassesses capabilities vis-à-vis the challenges of present and future security requirements. As the PA Nursing Service seeks to maintain a highly motivated, disciplined and competent pool of professional health workers, it also adopts modern health care procedures and techniques. The publication therefore of this revised Philippine Army Nursing Service Administration Manual is very timely as it merges into correct perspective the traditional theories and practices with the latest policies and methodology. This Manual also simplifies and standardizes many ways to accomplish the Nursing Service mission which is to provide the best nursing care possible to all PA personnel, their dependents and authorized civilians through efficient administration, supervision, training and evaluation of the Nursing Service personnel in accordance with the standards of safe nursing practice. I therefore enjoin all those involved in health care to make use of this Manual in the pursuant of professional development and technical excellence.

JAIME S DELOS SANTOS Lieutenant General, AFP

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AMENDMENT CERTIFICATE

1. Proposals for amendment or additions to the text of this manual should be made through the normal channels to the sponsor. A sample format of an amendment proposal is found in Annex P of PAM 8-01. 2. It is certified that the amendments promulgated in the under-mentioned amendment list have been made in this manual.

Amendment List Amended by (Printed Name and Initials)

Date of Amending Number Date

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

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PREFACE 1. Purpose.

This manual provides a doctrine for the planning, organization, implementation and supervision of the Army-wide nursing service.

2. Scope and Applicability.

This publication includes basic guidance on the management of human resources comprising of Army Officers, Enlisted Personnel and Civilian Employees in relation to their roles and functions in the accomplishment of mission. It also aims to provide guidance to line commanders and personnel staff officers on the integration of personnel activities and functions to strategically align them with the attainment of the PA’s vision, mission, goals and objectives. 3. User Information.

The proponent of this manual is the Office of the Assistant Chief of Staff for Personnel, G1, PA and is responsible in the review and update of this publication. Send comments and recommendations to the said Office at Fort Bonifacio, Makati City, 1201. 4. Reference. The following references were used in this publication: Strategic Doctrines

AFP Basic Doctrine, AFPM 0-1 Philippine Army Basic Doctrine, PAM 0-1, HPA, January 1996 Related Manuals AFP National Military Strategy, 2001 Philippine Army Officers Career Management Manual, 2001 AIM Strategic Human Resource Management for the PA, 2002 USA FM 100-1 Personnel Management, 2001

Australian Command and Staff Course, People Management, 2001

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5. Recession

All publications, manuals and directives inconsistent with this manual are hereby rescinded. 6. Gender

Unless this publication states otherwise, masculine nouns and pronouns do not refer exclusively to men.

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CONTENTS

Letter of Promulgation i Foreword iii Amendment Certificate v Preface vii Contents ix

Section Title Page CHAPTER 1 – INTRODUCTION

1-1 Vision, Mission, Goal and Philosophy 1-1 1-2 Historical Background 1-3 1-3 Composition and Exercise of Command 1-3

CHAPTER 2- ORGANIZATION AND FUNCTIONS

2-1 Organization 2-1 2-2 Office of the Army Chief Nurse 2-3 2-3 Organization of Nursing Services in PA Health Care

Facility 2-10

2-4 Military and Civilian Employee Assigned Nursing Service of General/ Tertiary Hospital, Station/ Secondary Hospital and Medical Infirmary

2-10

CHAPTER 3 – HUMAN RESOURCE MANAGEMENT

3-1 Human Resource Management Function 3-1 3-2 Assignment and Utilization of Nurse Corps Officer 3-3 3-3 Extension of Tour of Active Duty/ Retention of Nurse

Corps Officers 3-6

3-4 Promotion of Nurse Corps Officers 3-8 3-5 Separation of Nurse Corps Officers 3-11 3-6 Evaluation of Nurse Corps Officers 3-14 3-7 Recruitment and Selection of Appointment of PA

Nursing Service Civilian Employees 3-21

3-8 Management and Utilization of PA Nursing service Civilian Employees

3-22

3-9 Promotion of PA Nursing Service Civilian Employees 3-22 3-10 Termination of Employment of PA Nursing Service

Civilian Employees 3-23

3-11 Evaluation of PA Nursing Service Civilian Employees 3-24 3-12 Career and Personnel Development of PA Nursing

Service Civilian Employees 3-25

3-13 Morale and Welfare 3-26 3-14 Awards and Decorations 3-45 3-15 Uniform 3-53

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CHAPTER 4 – OPERATIONS

4-1 Nursing Service Administration and Management 4-1 4-2 Principles/Functions of Management 4-3 4-3 Total Quality Management 4-16 4-4 Nursing Process 4-24

CHAPTER 5 – MANAGEMENT OF CLIEN'T CARE

5-1 Extended Functions of Nurse Corps Officers 5-1 5-2 Emergency and Disaster Nursing Management 5-1 5-3 Health Service Support 5-4

CHAPTER 6 - HUMAN RESOURCE

DEVELOPMENT PROGRAM

6-1 Military Training and Education 6-1 6-2 Professional Advancement Program 6-3 6-3 In-Service Training Program 6-8 6-4 Paramedical Training in Army Health Care Facility 6-11

CHAPTER 7 - CONDUCT AND DISCIPLINE

7-1 Standards and Policies 7-1 7-2 Nursing Activities in the Ward 7-2 7-3 PA Nursing Service Personnel Discipline 7-3

CHAPTER 8 - NURSES AND THE LAW

8-1 Code of Ethics for Nurses in the Philippines (PNA Code for Nurses)

8-1

8-2 Scope of Professional Nursing Practice (R.A No. 7164 “Philippine Nursing Act of 1991)

8-2

8-3 Nurse’s Legal Responsibility for Client Care 8-3 8-4 Right and Responsibilities 8-12

CHAPTER 9 - ADMINISTRATIVE TOOLS

9-1 Records/Reports 9-1 9-2 Forms 9-5 9-3 Documentation 9-12

A Organization A-1 B Uniforms B-1 C Utilization of Nurse Corps in Echelons of Medical

Evacuation C-1

D PA Nursing Service Medication Sheet D-1 E PA Nursing Service Nurses’ Progress Notes E-1 F AFP Officer Appraisal System F-1 G Career Development Program For Nurse Corps G-1

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Officers In The AFP H Policies Governing Marriage, Pregnancy And

Maternity Leave Of Female Members Of The Active Force Of The AFP

H-1

I Circular Nr 01 AFP Technical Services Uniform I-1 Record of Changes Recommendation for Changes

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CHAPTER 1 INTRODUCTION

Section 1-1 Vision, Mission, Goal and Philosophy

1. Vision. The Army Nursing Service envisions a globally competitive and technologically driven caring Nursing Service. 2. Mission. The Nursing Service of the Army achieves its vision by providing the best nursing care possible to all PA personnel, their dependents and authorized civilians through efficient administration, supervision teaching and careful evaluation of the nursing service, professional and non-professional personnel in accordance with the standard of safe nursing practice. 3. Goal. A Nursing Service capable of providing quality nursing care encompassing the primitive, preventive, curative and rehabilitative spheres to all PA personnel, their dependents and authorized civilians. 4. Philosophy. The PA Nursing Service is dedicated to reflect in all its activities the promotion of health, prevention of diseases of all PA clients, their dependents and authorized civilian and the advancement of professional and administrative growth of all members of the nursing service.

To achieve excellence in Nursing Service, nursing practice and nursing leadership, the PA Nursing Service is guided by the following beliefs:

a. Excellence in Nursing Service (Client Care).

1) Each client regardless of circumstances possesses intrinsic value from God and should be treated with dignity and respect.

2) Each encounter with clients, their families and friends should portray compassion and concern.

3) Each client should receive quality care that is prompt, cost effective, responsive and. based on the latest technology.

4) The client confidentiality and privacy should be preserved.

5) Meeting the needs of client should always be the primary priority.

b. Excellence in Nursing Practice (Professional Growth).

1) Nursing is an art and science, the essence of which is nurturing and caring.

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2) A nurse's primary commitment is the restoration and

promotion of health of our clients in a sprit of compassion and concern.

3) The Nursing Process is an integral part of a professional nurse's practice.

4) Nurses should collaborate with other health care team members to meet the holistic needs of their clients which include the physical, psychosocial and spiritual aspects of care.

5) Client and family/significant others' education should be aggressively promoted to allow each individual the opportunity to prevent illness and achieve optimal health.

6) Nurses are accountable to their clients and their clients' families as well as to each other for professional practice.

7) Monitoring and evaluating Nursing Practice is a necessary responsibility to continuously improve care.

8) Professional growth and development should be pursued through education, research and participation in professional organizations.

c. Excellence in Nursing Leadership (Administrative Growth)

1) Nurses should provide a progressive environment, utilizing current technology.

2) Nurses should be guided by responsible stewardship to promote the highest quality client care, and personal satisfaction.

3) Nurses should encourage and support collaborative decision-making by those who are closest to the situation even at the risk of failure.

4) Compassion should be demonstrated in day to day personal interactions as well as a guide in decision-making.

5) Nurses should be sensitive to individual needs and give support, praise and recognition to encourage professional and personal development.

6) Nurses should possess an energy level and personal style that empower and inspire enthusiasm in others.

7) Nurses should consider suggestions and criticisms as challenges for improvement and innovation.

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8) Justice should be applied equitably in all employment practices and personal policies.

Section 1-2 Historical Background

5. Early Beginnings. The forerunner of the Nurse Corps of the Armed Forces of the Philippines was the Army Nurse Corps, which was created on 5 September 1938 by virtue of Commonwealth Act No. 385. This Act provided that the Medical Service shall consist of the Medical Corps, the Dental Corps, the Veterinary Corps, the Nurse Corps and the Medical Administrative Corps. This Act was implemented by Executive Order No. 267 of April 1940, which further provided for the qualifications, appointments, classification and compensation of members.

Republic Act No. 203 dated May 12, 1948 made the Nurse Corps an integral part of the Armed Forces of the Philippines directly under the Medical Service, This law, among others, gave the members of the Nurse Corps equal rights and privileges as any other member of the Armed Forces. 6. Expansion. When the Armed Forces of the Philippines were reorganized, the Philippine Army became one of the four major commands. As a result, the Office of the Chief Surgeon, Philippine Army was activated on March 1965 with the Chief Nurse, Philippine Army as a staff officer to advice on matters pertaining to Nursing. 7. The Philippine Army Nursing Service. With the implementation of GO No. 510, GHQ, AFP dated 28 June 1973 the Nurse Corps was administratively separated from the Medical Corps. Because of this separation, The Office of the Chief Nurse for each of the Major Services was activated. Effective 01 September 1973, Chief Nurse, Philippine Army became a special staff to the Commanding General, Philippine Army.

Section 1-3 Composition and Exercise of Command

8. Composition. The PA Nursing Service is composed of three (3) general categories of personnel:

a. Nurse Corps Officers.

1) Regular (RA 291). These are career NC officers whose tenure of service can be terminated only for a cause or by request of the individual.

2) Reserve (RA 6441). These are NC Officers who served with either the Philippine Contingent (PHILCON) or the Philippine Civic Action Group (PHILCAG) in Vietnam for a period of not less than six (6) months.

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Their tenure in the service is like the RA 291 officers and they can he separated only for cause or by request of the individual.

3) Reserve (RA 2334). These are NC Officers on active duty who are covered by RA 2334 and whose tour of active duty lasts three (3) years (1st request) another three (3) years (2nd request) and four (4) years (3rd request). After ten

4) Years of active duty" they are accorded the Security of Tenure (SOT) wherein they can be separated only for cause or by request of the individual.

b. Civilian Employees.

1) Nurses. These are graduates of Baccalaureate Program in Nursing and are licensed to practice nursing in the Philippines. They may be hired as regular, casual/ contractual.

2) Midwives. These are Midwifery Course graduates who are licensed to practice midwifery in the Philippines. They may be hired as regular, casual/contractual.

3) Nursing Attendants/Institutional Workers/Utility Workers. These are the skilled and semi-skilled non-professional workers and may be hired as regular, casual/ contractual.

These civilian employees maybe hired as:

1) Regular. Employees of the AFP who are covered by the Civil Service Commission and appointed by the Department of National Defense (DND). They can stay in the service until they retire and can be removed from the service only for cause.

2) Casual/Contractual. Employees who may be promoted to regular and whose tenure of service may be extended or terminated depending on their performance and availability of funds.

c. Enlisted Personnel.

1) Medical Corpsmen. These are the highly trained male enlisted personnel who may work in progression of responsibility according to the degree of medical training and experience.

2) Women Auxiliary Corps (WAC). These are highly trained female enlisted personnel who may work in progression of responsibility according to the degree of medical training and experience. 9. Exercise of Command. Nurse Corps officers may exercise technical and administrative functions only within their own branch of service and over personnel placed under their control.

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CHAPTER 2 ORGANIZATION AND FUNCTIONS

Section 2-1 Organization

1. General. The provisions in this chapter are in accordance with AFPR G 161 - 192 dated 26 April 1989. 2. Organization. The organization of PA Health Care Facilities is categorized according to capabilities.

a. General/Tertiary Hospitals. Hospitals that have capabilities and facilities for providing medical care to cases requiring sophisticated diagnostic and therapeutic equipment and expertise of trained specialists in their sub-specialties.

b. Station/Secondary Hospitals. Hospitals that have capabilities

and facilities for medical care to cases requiring hospitalizations and have the expertise of trained specialists.

c. Medical Infirmaries. Health care facilities intended primarily to

provide routine (out-patient/non-hospital) medical assistance and to confine clients with acute cases of influenza, diarrhea, and other medical cases which need two (2) to three (3) days confinement only.

Types of Medical Infirmaries:

1) Fixed or Station. These facilities are permanent and situated/located inside camp or garrisons to provide health care and treatment to all the personnel and their dependents in the area. They do not move nor follow the movements of any military unit assigned in said area.

2) Field or Mobile. These facilities are organic to bigger

military units from battalions up and are required to move and follow where the mother unit goes. 3. Organization of PA Nursing; The organization of PA Nursing Services is composed of the Nursing Services of the various PA Health Care Facilities (Annex AI) under the technical and administrative supervision of the Office of the Army Chief Nurse.

a. Nursing Service, Fort Bonifacio General Hospital b. Nursing Service, Army Station Hospital, 1ID

c. Nursing Service, Medical Company, lID

d. Nursing Service, Army Station Hospital, 2ID

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e. Nursing Service,. Medical Company, 210

f. Nursing Service, Army Station Hospital, 3ID

g. Nursing Service, Medical Company, 3ID

h. Nursing Service, Army Station Hospital, 4ID with a Satellite

Hospital Annex at Bancasi, Butuan City

i. Nursing Service, Medical Company, 4ID j. Nursing Service, 4DTU Med Infirmary, 403rd Bde, 4ID

k. Nursing Service, Army Station Hospital, 5ID

l. Nursing Service, Medical Company, SID

m. Nursing Service, Army Station Hospital, 6ID (One ward is

Located in General Santos City District Hospital)

n. Nursing Service, Medical Company, 6ID o. Nursing Service, Army Station Hospital, 7ID

p. Nursing Service Medical Company, 7ID

q. Nursing Service, FSRH. Medical Infirmary, SOCOM

r. Nursing Service, SFR Medical Infirmary, SOCOM

s. Nursing Service, Army Station Hospital 8ID

t. Nursing Service, Medical Company, 8ID

u. Nursing Service, LABde Medical Infirmary

v. Nursing Service, 51st EBde Medical Infirmary

w. Nursing Service, S2ml EBde Medical Infirmary

x. Nursing Service, 53rd EBde Medical Infirmary y. Nursing

Service, 54th EBde Medical Infirmary z. Nursing Service, 55th EBde Medical Infirmary

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Section 2-2 Office of the Army Chief Nurse

4. Activation. The Office of the Chief Nurse, Philippine Army was organized as a special staff of Headquarters; Philippine Army effective 01 September 1973 pursuant to GO Nr 112 HPA dated 30 August 1973. 5. Mission. The mission of the Army Chief Nurse is to ensure safe nursing practice and the delivery of comprehensive, quality nursing care to the PA wide clientele. 6. Command Relationship. The Office of the Army Chief Nurse (OACN), is under the general supervision of the Chief of Staff, Philippine Army and under the functional supervision of the Assistant Chief of Staff for Personnel, G 1. (Annex A) 7. Organization. The organization of the Office of the Army Chief Nurse ;( Annex A2) as a Technical/Special Staff of the Office of the Commanding General, PA. (Annex A) 8. Qualifications, Functions, and Responsibilities of Personnel, Office of the Army Chief Nurse.

a. Army Chief Nurse.

1) Qualifications: a) Rank of Colonel

b) AFPOS of Nursing Service, Administration with

Proficiency Designation of A

c) GSC eligible

d) Holder of Master's Degree in Nursing Major in Nursing Service Administration/related health fields

e) Has at least eighteen (18) years practice in Military Nursing

f) Holder of a current license to practice nursing in the Philippines

g) Certified current IV Therapy train or

h) Demonstrated capability to organize, coordinate and lead the PA Nursing Service

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2) Functions/Responsibilities:

a) Advises the Commanding General, Philippine Army on all matters pertaining to and affecting the Nurse Corps, Philippine Army.

b) Ensures that policies and standards of nursing

practice are maintained and to assess nursing service requirements in PA Health Care Facilities through staff visits and inspections.

c) Formulates professional standards of safe nursing

practice in the Philippine Army Nursing Service.

d) Coordinates with The Chief Nurse Corps, Armed Forces of the Philippines (TCN, AFP) on all matters regarding recruitment, appointment, classification, promotion, retention and separation of PA Nurse Corps Officers.

e) Coordinates/recommends to the Chief Surgeon, PA policies pertaining to the PA Nursing Service for incorporation in the PA Medical Service.

f) Attends staff conferences especially when PA

nurses are involved.

g) Coordinates with commanders of PA subordinate units through their respective Chief Nurse or Nurse-In-Charge regarding assignments and other personal matters affecting Army NC officers.

h) Plans, coordinates, and implements all training

programs for the Nursing Service.

i) Determines requirements for procurement, retention and separation of Nurse Corps Officers assigned Nursing Service and ensures a well maintained Management Information System (MIS) of the Nursing Service

b. Deputy Army ,Chief Nurse.

1) Qualification: Same as Army Chief Nurse. 2) Functions/Responsibilities:

The Deputy Army Chief Nurse assists the Army Chief

Nurse in the performance of the latter's staff functions and acts in her behalf during her absence and supervises the staff functions of the Administrative and Personnel Management Branch, and the Plans, Organization and Training Branch.

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c. Chief, Plans, Training and Organization Branch, OACN

1) Qualifications:

a) Rank of Lieutenant Colonel b) GSC eligible

c) Holder of a current license to practice nursing in

the Philippines

d) Holder of Master's Degree in Nursing Administration Major in Nursing Administration/related health fields

e) Certified current IV Therapy trainor


a) Coordinates, integrates and consolidates training activities/programs of the Nursing Services of the various PA health care facilities.

b) Prepares and coordinates the organization and

program of activities of all PA military and civilian employees assigned Nursing Service

c) Reviews/recommends doctrines to ensure quality nursing care.

d) Maintains PA Nurse Corps distribution list and coordinates its updating for current planning.

e) Recommends priorities for personnel allocation and training for PA Nurse Corps officers.

f) Assesses and programs Nursing Service requirements in consonance with current trends in Nursing practice.

g) Conducts/participates in research to improve nursing practice.

h) Chief Ensures implementation of standards nursing practice. of safe

d. Chief, Administrative and Personnel Management Branch, ACN.

1) Qualifications

a) Rank of Major

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b) Demonstrated oral and written communication skills.

c) Holder of a current license to practice nursing in the Philippines

d) Holder of Master's Degree in Nursing Major in Nursing Administration/related health fields.

e) Demonstrated the ability to supervise office management.

f) Certified current IV therapist

g) Completed the Personnel Officers' Course

2) Functions / Responsibilities:

a) Responsible for the management of information system in the office.

b) Ensures effective human resource planning and

development

c) Recommends to the Army Chief Nurse policies affecting morale and welfare of PA Nurse Corps officers.

d) Establishes, interprets personnel policies and promotes good personnel relations and morale.

e) Monitors for the Army Chief Nurse, the career management of PA Nurse Corps Officers

e. Chief Clerk, OACN.

1) Qualifications:

a) Rank E-7 b) Undergone training in Advance NCO Course

c) With an AFPOS of Medical Specialist

d) A graduate of Advance NCO Course


a) Sorts / checks all incoming and out going

communication/message and other miscellaneous intended for the Office of the Army Chief Nurse.

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b) Records a11 commitments/appointments and

other related activities of the Army Chief Nurse and staff in the daily journal and to the bulletin board.

c) Coordinates with the assigned EP this office regarding schedules of fatigue day, cleaning of the office and its surroundings.

d) Assists his Chief of Office in their respective job assignments.

e) Type’s communication as the Army Chief Nurse may direct.

f. Finance Sergeant, OACN.

1) Qualifications:

a) Rank of E-5 b) With an AFPOS of Medical Specialist

c) With Financial Management Training


a) Ensures that all vouchers/payrolls for whatever

claims in nature are properly coordinated/followed up with the office concerned.

b) Draws salaries of OACN personnel from the

finance officer and give to all recipients.

c) Processes financial concerns of the Office of the Army Chief Nurse.

d) Ensures that all financial matters are properly and timely processed and accounted for.

g. Supply Sergeant, OACN.

1) Qualifications:

a) Rank of E-5 b) With an AFPOS of Medical Specialist

c) Knowledgeable in the management of office

equipment and supplies.

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d) With Logistics Management Training.


a) Ensures that all supplies and equipment of the Office are properly maintained and accounted for.

b) Checks and maintains stock level of supplies and

ensures that all items are properly recorded.

c) Ensures that all books, magazines in the office are properly accounted for. Maintains a borrower's card.

d) Maintains records of MRs and RIVs.

e) Presents and accounts all deliveries of supplies and equipment.

h. Message Clerk.

1) Qualifications:

a) Rank of E-S. b) With 2m AFPOS of Medical Specialist.

c) Knowledgeable in correspondence.

d) Demonstrated skill in the use of typewriters,

computers fax machine, copier machine.


a) Maintains file of outgoing. and communications b) Updates roster of military personnel and MPFs.

c) Assists in the preparation of office reports.

d) Ensures that personnel policies and procedures

are properly compiled and secured.

e) Follows-up papers for commission, reversion, separation and other matters pertaining to all military and civilian employees assigned PA Nursing Service.

f) Ensures that all outgoing communications are transmitted on time.

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i. Driver/Mechanic, OACN.

1) Qualifications:

a) Rank of EA. b) With an AFPOS of Medical Specialist.

c) Demonstrated skills in proper and safe driving

acquired through formal training.

d) Knowledgeable in vehicle maintenance acquired through formal training.

e) Knowledgeable of traffic rules and regulations as mandated.


a) Maintains the road worthiness and cleanliness of all vehicles.

b) Ensures that vehicles are registered and driven by

driver with license.

c) Reports all noted defects of vehicles to the Admin Officer.

d) Secures vehicles in designated motor pools.

j. Civilian Clerk.

1) Qualifications:

a) Civil service eligible b) With earned units in college level

c) A, graduate of Basic Civilian Personnel Course

2) Functions/Responsibilities

a) Encodes all communications of the Office of the Army Chief Nurse.

b) Assists the message clerk in updating and maintenance of MPFs of all PA Nurse Corps officers.

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c) Receives, sorts, records, files incoming communications and presents them to ACN and staff for appropriate actions.

d) Maintains files of outgoing communications.

k. Janitor/Institutional Worker.

1) Qualifications:

a) High school graduate b) Physically and mentally fit

2) Function/ Responsibilities

a) Maintains clean and sanitary conditions in

assigned area as directed according to the established standards, observing proper cleaning and disinfec1ing techniques.

b) Exercises economical use of supplies and due

care of equipment.

Section 2-3 Organization of Nursing Services in PA Health Care Facility

9. Organizational Relationship of the Nursing Services "with the other Services in PA Health. Care Facilities. The Nursing Service has a clear distinct identifiable Structure in the organization which is on equal line with the major services of the PA health care facilities e. g. Administrative, Medical Services (Annex A3). 10. Organization of the Nursing Service of a General/Tertiary Hospital (Annex A4) 11. Organization of the Nursing Service of Station/ Secondary Hospital (Annex AS) 12. Organization of the Nursing Service of a Medical Infirmary ( Annex A6)

Section 2-4 Military and Civilian Employee Assigned Nursing Service of

General/ Tertiary Hospital, Station/ Secondary Hospital and Medical Infirmary

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13. General. The PA Nursing Service staff functions best when qualified care givers, each knowing its functions and responsibilities are linked together as members of a highly effective team group with mutual objectives. 14. Qualifications/Functions/Responsibilities of Professional Workers of the Nursing Service. In order to have a Nursing Service that is efficient, effective, relevant and responsive, the Army Chief Nurse has set the following qualifications, functions, responsibilities of the different nursing service care givers of all PA health care facilities. 15. General/Tertiary Hospital

a. Chief Nursing Service. This designation is given to a Nurse Corps officer assigned in a general/tertiary hospital who is responsible for the overall administration and supervision of the Nursing Service.

1) Qualifications:

a) Rank of COL b) AFPOS of Nursing Administration

c) GSC eligible

d) Holder of a current license to practice nursing in

the Philippines.

e) Holder of Master's Degree in Nursing Major in Nursing Service Administration/related health fields.

f) Certified current IV Therapy Trainor

g) With at least fifteen (15) years experience in Military Nursing including two (2) years as Asst Chief Nurse of a General Hospital.

2) Functions/ Responsibilities:

a) Assures client a quality care. b) Evaluates Nursing Service needs and determines

staffing requirements and coordinates activities of the Nursing Service with other sections.

c) Coordinates with Army Chief Nurse through the Commanding Officer of the general hospital in matters pertaining to and affecting the Nursing Service care givers.

d) Determines appropriate Nursing Service budget.

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e) Identifies and solves department and employees' Problems.

f) Evaluate all military and civilian employees assigned Nursing Service in accordance with AFP or Civil Service regulation and standards of safe nursing practice

g) Updates, updates, and revises policies, procedures and job descriptions to meet current objectives and standards.

h) Updates his knowledge and skills on current trends in nursing through attendance of meetings, conferences, conventions, seminar /workshops, in-service trainings and readings of current publications pertaining to all aspects of client care.

b. Assistant Chief Nurse, Nursing Care Branch.

1) Qualifications:

a) Rank of COL b) With appropriate AFPOS

c) GSC eligible


the Philippines.

e) Holder of Master's Degree in Nursing Major in Nursing Service Administration related health fields.


g) With at least twelve (1'2) years experience in military Nursing including three (3) years as clinical supervisor,

2) Functions/Responsibilities

a) Plans and supervises over-all client care. b) Receives daily report of ward activities and

communications from the different clinical supervisors.

c) Assesses nursing care in the wards and other special areas.

d) Makes recommendations relative concerning client care. to the problem

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e) Assists the Chief Nursing Service in the supervision of nursing care.

f) Evaluates performance of all military and civilian employees assigned Nursing Service.

c. Assistant Chief Nurse, Nursing Education and Training Branch.

1) Qualifications:

a) Rank of CO L b) With AFPOS as Nurse Educator 32Q

c) GSC eligible


the Philippines.


f) Certified current IV therapy trainor/preceptor.


a) Plans, organizes and evaluates training programs for all military and civilian employees assigned Nursing Service.

b) Formulates updates, publishes and disseminates

relevant nursing training programs.

c) Participates in the evaluation of Nursing Service staff and renders OER/EPEM/NPES.

d) Establishes linkages with professional organizations within and outside the military establishment.

e) Assists the Chief Nursing Service in identifying training and learning needs of all military and civilian employees assigned Nursing Service.

d. Assistant Chief Nurse, Nursing Research and Quality (

Assurance Branch).

1) Qualifications:

a) Rank of COL

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b) With appropriate AFPOS

c) GSC eligible

d) Holder of a current license to practice nursing in the Philippines



g) Demonstrated skill in research


a) Formulates and implements Continuous Quality Improvement Program.

b) Participates/conducts researches on nursing and related studies.

c) Assesses and recommends revision of policies, standards of nursing practice, procedures and regulations.

e. Assistant Chief Nurse, Nursing Administrative Branch.

1. Qualifications:

a) Rank of LTC b) With AFPOS of Nursing Administration 32A

c) GSC eligible


the Philippines.


f) Certified current IV Therapist

2. Functions/Responsibilities:

a) Responsible in the management information system of the office

b) Recommends to the Chief Nursing Service policies

affecting morale and welfare of personnel

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c) Ensures effective human resource planning and

development.

f. Clinical Supervisor. This designation is given to a senior Nurse Corps officer who supervises and coordinates ward activities and administrative management to provide continuity of nursing care.

1. Qualifications:

a) Rank of Major b) With appropriate AFPOS, Prefix A in nursing

specialty and Prefix B in Nursing Administration 32A.

c) Holder of a current license to practice nursing in the Philippines.

d) Holder of a Master's Degree in Nursing Major in Nursing Service Administration/related health fields.

e) A graduate of Technical Service Officers' Advance Course


2. Functions / Responsibilities:

a) Directs and supervises nursing service of a group of client care units to provide best care attainable.

b) Recommends/Participates/Coordinates in

preparation of nursing budgets.

c) Supervises, coordinates, development programs. participates in staff

d) Evaluates the performance of military and Civilian employees assigned Nursing Service utilizing the appraisal system established by the Nursing Service (OER for NC Officers, EPEM for Enlisted Personnel and NPES for Civilian Employees)

e) Gathers information pertinent to the status of staff, unit equipment! Facilities, supplies and materials

g. Head nurse/Charge Nurse. This designation is given to the NC Officer who is responsible for the nursing care in one nursing unit.

1. Qualifications:

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a) Rank of CPT b) With appropriate AFPOS.


the Philippines.

d) With at least nine (9) units in any management courses at the graduate level.

e) At least seven (7) years experience in military nursing to include five (5) years experience as a staff nurse.

f) A graduate of Technical Service Officers Advance Course.

g) Certified current IV therapist.


a) Assesses/classifies the overall nursing care needs of clients.

b) Formulates general program of nursing care based

on the clients' assessed needs.

c) Coordinates the implementation of each client's nursing care plan with the different categories and levels of health care professionals/entities.

d) Evaluates the efficiency and effectiveness of nursing care delivered.

e) Determines/allocates equitable assignments in the ward. Workload

f) Evaluates the performance of all military and civilian employees assigned Nursing Service based on the established evaluation parameters.

g) Employs individual employee conferences and counseling techniques to promote positive work attitudes and to motivate the staff to meet/exceed standards of performance.

h) Attends/coordinates/participates in staff development activities.

i) Ensures adequacy of facilities/equipment/supplies materials pertinent to meeting the needs of clients and care givers through their sufficiently justified proposals.

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h. General Duty Nurse. This designation is given to a newly CAD

Nurse Corps Officer.

1. Qualifications:

a) Rank of 2LT b) Holder a current license to practice nursing in the

Philippines

c) Certified current IV therapist

2. Functions and responsibilities:

a) Accomplishes nursing histories and assessments in order to identify common variables affecting nursing care.

b) Identifies and analyzes common current client's

problems, symptoms and behavioral changes.

c) Plans, implements, documents and evaluates individualized nursing care utilizing assessment data involving client/family and significant others to include health education.

d) Participates in the educational program of clients and significant others.

e) Participates in the educational program and evaluation performance of nursing students and auxiliary workers.

f) Ensures availability of medicines, nursing supplies and equipment at all times.

g) Provides safe, clear and orderly environment for clients.

i. Public Health Nurse. This designation is given to a Nurse Corps Officer with AFPOS of Public Health Nurse 32P.

1. Qualifications:

a) Rank of lLT b) Has undertaken Special Courses trainings in

Public Health/ Public Health Nursing

c) Holder of a current license to practice nursing in the Philippines.

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d) A graduate of Technical Service Officers Basic Course

e) Certified current IV therapist


a) Collects and updates individual, family and community data base in a systematic and complete manner.

b) Identifies common, recurrent and potential

problems relative to health status of the population, community resources arid administration.

c) Sets priorities for health action based on criteria set such as: magnitude of the problem, resources and community capabilities, existing policies and guidelines.

d) Plans, programs the nursing care with the identified and priotized problems to serve as guide for all those involved in the nursing actions.

e) Carries out nursing activities which may include; administration of direct services, monitoring activities, teaching, and improvising, counseling, referrals to appropriate service/professionals.

f) Evaluates extent to which nursing activities and outcomes of care to individuals and families are carried out or achieved.

j. Nurse Officer of the Day (NOD). This designation is given to the

NC Officer who goes on 24 hours duty in a general/station hospital. 1. Functions/ Responsibilities

a) Augments the afternoon and night shifts when abnormally busy. In extreme emergencies, the supervisor. On duty may call all available military nurses to include Nurse on Duty to augment any or all shifts.

b) Ensures that Nursing Service personnel who are

sick in quarters (nurses' quarters/female BOQ) receive appropriate medical and nursing management.

c) Communicates unusual/necessary activities of the day to the Chief Nursing Service.

k. Civilian Staff Nurse I.

1. Qualifications:

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a) BSN graduate b) A certified current IV Therapist

c) Holder of current license to practice nursing in the

Philippines

d) Have passed the competency and mental ability tests and physical examination given by the appropriate AFP body, and cleared by the proper military security agency.


a) Identifies, plans, implements and evaluates

nursing needs of clients.

(1) Obtains nursing history and performs physical assessment

(2) Identifies subjective and objective problems

of clients.

(3) Detects abnormalities from the assessment and result of diagnostic examinations and reports.

(4) Establishes nursing diagnosis

(5) Prioritized needs and problems of clients.

(6) Formulates short and long term objectives based on the acronym SMART, Discharge Plan initiated based on the acronym METHOD

(7) Executes plans of care/administers prescribed medications and treatments and documents in the medication sheet and nurses' progress notes.

(8) Documents client's response to care in the nurses' progress notes.

(9) Revises plans of care as necessary

(10) Completes and accurately fills-up clinical forms.

b) Participates in providing adequate, safe, orderly and clean environment for clients and care givers.

l. Civilian Staff Nurse II.

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1. Qualifications:

a) BSN Graduate b) Certified current IV Therapist


the Philippines

d) Have passed the competency and mental ability tests and physical examination given by the appropriate AFP body, and cleared by the proper military security agency.

e) A graduate of Civilian Personnel Basic Course


Same as functions of Civilian Staff Nurse I

m. Civilian Staff Nurse III.

1. Qualifications:

a) Have earned at least nine (9) units in any management courses at the graduate level.

b) Certified current IV Therapist


the Philippines

d) Have passed the competency and mental ability tests and physical examination given by the appropriate AFP body, and cleared by the proper military (security agency.

e) A graduate of Civilian Personnel Supervisory Course.

2. Functions /Responsibilities

In addition to functions of Civilian Staff Nurse I & II:

a) Plans/Conducts teaching development programs of all nursing civilian employees assigned in the area.

(1) Orients nursing service civilian employees. (2) Evaluates ward accomplishments/

performance of nursing service civilian employees.

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(3) Plots work/ duty schedules of nursing service civilian employees

(4) Conducts nursing conferences. rounds and monthly

(5) Conducts daily inventory of stock level of supplies and requests medicines/supplies needed in the area.

n. Civilian Midwife I.

1. Qualifications:

a) Registered midwife with current license to practice. b) Have passed the competency and mental ability

test and physical examinations given by the appropriate AFP body and cleared by the proper military security agency.


a) Handles and assists normal deliveries and

performs neonatal care to newborn with supervision.

(1) Monitors client's vital signs, fetal heart beat and record.

(2) Monitors client's progress of labor and

record.

(3) Handles normal deliveries.

(4) Assists doctors in abnormal deliveries.

(5) Assesses/renders neonatal care to newborn to include cord dressing.

b) Renders direct care and evaluates care given to obstetrical clients.

c) Participates in health education on prenatal and post partum care.

d) Participates in providing adequate, safe orderly and clean environment for clients.

e) Maintains accurate and complete records and reports.

(1) Attends endorsement and ward rounds.

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(2) Maintains records of deliveries, dilatation

and curettage and other OB Gyne procedures and reports as required.

(3) Maintains updated consumption and utilization reports and records of medical and nursing supplies.

(4) Maintains updated records of available equipment and their status of serviceability.

(5) Assists the head nurse in the preparation of reports.

o. Civilian Midwife II and III.

1. Qualifications:

a) Registered midwife with current license to practice.

b) Have passed the competency and mental ability test and physical examinations given by the appropriate AFP body and cleared by the proper military security agency.

c) A graduate of Civilian Personnel Basic Course.

d) Must have at least three (3) years length of service for Midwife II and five (5) years for Midwife III.

e) Must have NPES ratings of Very Satisfactory for two successive years immediately before consideration for promotion

2. Functions/Responsibilities: Same as the

functions/responsibilities of Civilian Midwife 1. 16. Non Professional Nursing Service Personnel.

a. Ward master. This designation is given to a senior enlisted personnel in a nursing unit under the supervision and direct responsibility of the head nurse.

1. Qualifications:

a) Rank of E-7 b) With AFPOS of Medical Specialist

c) A graduate of Medical Aidman Advanced Course

d) Demonstrated skills in performing simple

delegated basic nursing procedures

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a) Executes direct administrative supervision over

ward men and subordinates assigned in the area. b) Ensures that a comfortable and safe environment

for clients is maintained at all times.

c) Ensures that all records of equipment and supplies to include linen supplies found in the unit are complete and updated.

d) Warrants that adequate stock of supplies to include linen supplies is always available.

e) Plans, publishes work/ off duty schedules for ward men and auxiliary workers assigned in his unit, in coordination with the head nurse.

f) Performs some simple, delegated, basic nursing care under the supervision of the head nurse.

g) Enforces discipline among the clients and ward men and subordinates in the nursing unit.

h) Assists the head nurse in acquainting the clients on rules/regulations of the nursing unit/hospital.

b. Ward man. A designation is given to an enlisted personnel assigned in the nursing unit.

1. Qualifications:

a) Rank of E-,3 to E-6 b) With AFPOS of Medical Specialist

c) Demonstrated the skill s in performing delegated

simple nursing procedures.

2. Functions/Responsibilities

a) Performs simple direct nursing care for the physical comfort and safety of clients under the supervision of the nurse.

b) Assist the ward master in the performance of his

duties.

c. Nursing Attendant. This designation is given to a non professional Nursing Service employee who assists the nurses and other care

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givers in the ward in providing indirect nursing care and some technical nursing services / care under the direction and supervision of a professional nurse.

1. Qualifications:


c) Has undertaken on-the-job training in basic

nursing procedures as temperature taking and others.


a) Assists/performs simple delegated nursing procedures under the supervision of the nurse.

b) Checks stock levels of ward supplies.

c) Assists the ward master and ward men in making

requisition of ward supplies.

d) Participates in the cleaning of the ward.

d. Janitor Institutional Worker. This designation is given to a non-professional worker who performs housekeeping and cleaning activities within an assigned area under the supervision of the head nurse and/or ward master.

1. Qualifications:



a) Ensures that assigned areas and surroundings are

kept clean and safe at all times.

b) Assists the ward man in collecting and sending soiled linens to laundry.

c) Reports observations concerning structural and

equipment defect to head nurse or ward master

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17. Station/Secondary Hospitals. The military and civilian employees assigned Nursing Service of station/secondary hospitals as well as its qualifications are the same as that of the general/tertiary hospital except that in a station secondary hospital there is no Assistant Chief Nurse, Nursing Research Branch. The function of research is subsumed to the Chief Nursing Service. 18. Medical Infirmary.

a. Nurse-in-Charge (NIC) .This designation is given to a Nurse Corps officer assigned in a Medical Infirmary. He is responsible for the overall administration and supervision of aU nursing and non nursing activities related to the overall total nursing management of out patient services.

1. Qualifications:

a) Rank of 1LT b) With an AFPOS 1S Public Health Nurse: 32P and

demonstrated the skills on epidemiological investigations.

c) Holder of a current licensure to practice nursing in the Philippines.

d) Certified current IV therapist

e) A graduate of Technica1 Service Officers Basic Course


a) Assists in the conduct of epidemiological investigations of profile of military personnel and dependents and participates and implementation of health impact program.

b) Estab1ishes and maintains linkages with GOs and

NGOs in the area of responsibility.

c) Conducts inspection of environmental sanitation inside military camps

d) Renders evaluation of personnel as mandated.

e) Assessing training needs and appropriate training programs. Implements

f) Warrants stock levels of supplies and efficient functioning of requirements.

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g) Responsible to the Commanding Officer of the Medical Infirmary and Army Chief Nurse

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CHAPTER 3 HUMAN RESOURCE MANAGEMENT

Section 3-1 Human Resource Management Function

1. General. This Chapter embodies procedures, policies and regulations governing the recruitment and appointment of Nurse Corps Officers in the Armed Forces of the Philippines in accordance with AFP Personnel Directive Nr 08-72 dtd 07, Jan 72 and Circular Nr 30 dtd 07 Dec 87. 2. Recruitment. This refers to the activities undertaken relative to the appointment of a qualified nurse applicant as a Regular /Reserve Officer. It does not include the call to active duty (CAD) or extended tour of active duty (ETAD) of those already appointed. Neither does it cover procurement by draft or compulsory military service.

a. The Chief Nurse, AFP shall process applications for Commission in the Nurse Corps, Regular/Reserve Force, AFP. I-Ie shall recommend the qualified applicants to the Chief of Staff, AFP through The Adjutant General (TAG) AFP and. the Deputy Chief of Staff for Personnel (DCSPER, Jl).

b. Qualifications for Commission in the Reserve Force, Nurse

Corps, AFP

1) Graduated from a recognized School/College of Nursing. 2) Passed the Board of Examination prescribed by law for

the practice of nursing with a rating of at least 80%.

3) Male and female candidates must be single and have never been married. Female applicants must not be positively found to have given birth to a living or still born child.

4) Must be a natural born Filipino citizen.

5) Must be mentally and physically fit for military service and cleared by appropriate security agencies.

6) Must have a pleasing personality and of good moral character.

7) Skillful in:

(a) Applying the nursing process in meeting health/ nursing needs of individuals, families, groups, communities.

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(b) Communicating and relating with others.

(c) Making sound/rational judgment in a given

situation.

(d) Interested and willing to work in both peacetime and wartime conditions in any part of the country or abroad, if necessary.

8) Satisfies the following height requirements: Male: minimum of sixty four (64) inches or 162.5 centimeters Female: minimum of sixty two (62) inches or 157.5centimeters.

9) Must not be more than thirty two (32) years of age at the

time of commission. 3. Grades on Appointment. After having been qualified for commission in the Regular or Reserve Force, a Nurse Corps Officer is appointed in the grade of 2nd Lieutenant by the President of the Philippines.

a. Qualifications for Commission. In Regular Force, Nurse Corps, AFP. In addition to the qualifications for commission in the Reserve Force, Nurse Corps, AFP; numbers 1-9 the applicant must not be more than twenty six (26) years of age at the time of Commission in the Regular Force as prescribed in Circular .Nr 14 dtd 10 Nov 94.

b. Appointment into the Regular Force, Nurse Corps, AFP:

1) The appointment of a nurse into the Regular Force,

Nurse Corps, AFP shall satisfy the basic requirements prescribed by the Nurse Corps, AFP.

2) The Chief Nurse (TCN) AFP is the recommending

authority for appointment into the Regular Force, Nurse Corps, AFP.

3) The Chief Nurse (TCN) AFP shall screen all applicants and require the qualified applicants to take an appropriate competitive examination for appointment. She shall select the applicants for submission to the Technical Service Regular Commission Board by verifying the entries in the application and determining the best qualified on the basis of the following factors, the weight of each to be determined by the recommending authority concerned.

(a) Result of competitive examination (b) Performance as an officer, if applicable

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(c) Performance in service schools

(d) AFPGCT score (for those required to take) (e) Educational attainment

(e) Board examination result

(f) Academic performance in college

(g) Professional experience

(h) Self-expression

c. Grades on Appointment: All appointments in the NC shall be in the grade of 2LT

4. Qualifications for Call to Active Duty in the Nurse Corps.

a. Must be commissioned in the Nurse Corps, AFP b. With at least one (1) year experience in a reputable health

agency

c. Must be cleared by appropriate security agencies

d. Passed the physical and mental examinations conducted by the appropriate authorities.

Section 3-2 Assignment and Utilization of Nurse Corps Officer 5. Assignment and Rotation. The Chief Nurse, AFP is responsible for the assignment/ rotation of the Nurse Corps officers. In like manner, the Army Chief Nurse is responsible for the assignment/rotation of Nurse Corps Officers assigned to the PA in accordance with the career management and development program of Ute individual and needs of the PA.

NC officers who are in the following categories shall not be considered for reassignment to combat zones or area of operations:

a. sick in hospital b. pregnant

c. with pending case

d. Enjoying accumulated leave prior to separation/ Retirement.

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e. enjoying preferential assignment prior to compulsory Retirement, and

f. undergoing schooling (local or abroad).

Rotation of NC officers shall be based on Armed Forces Occupational Specialty (AFPOS) requirement, rank authorized for specific slots and needs of the service.

Rotation of Nurse Corps officers in the Philippine Army conforms to the prescribed career profile particularly for the three (3) periods of development namely: Period of Clinical Development, Period of Professional Specialty Development and Period of General Development. 6. Utilization of Nurse Corps Officers. PA Nurse Corps. Officers shall be utilized in nursing duties either administrative or clinical appropriate to efficient accomplishment of the mission of the PA Nursing Service.

NC Officers are considered appropriately assigned when they are performing nursing duties. They shall not be designated to bear direct responsibility for ward property nor be assigned to non nursing duties.

Newly CAD Nurse Corps officers who had already undergone orientation/ familiarization training along their respective area of interest may be assigned to medical installations located in combat areas.

Assignment of NC officers to medical installations in combat areas shall be for a minimum of one (1) year and a maximum of two (2) years at anyone time. NC officers who have signified their willingness to stay longer in their field unit assignments may be allowed to do so subject to the approval of the Army Chief Nurse/The Chief Nurse, AFP provided it shall be for a maximum of two (2) terms or a total of four (4) years. 7. Designation of Chiefs of Technical Services in the Major Services and GHQ post units / AFPWSSUs. Authority: AGPCR2 - Standing Operating Procedure Nr 1 dtd 03 June 2004

a. References.

1) Implementing rules and regulations of RA 9188. 2) AFP Personnel Directive Nr. 5 GHQ, AFP dtd 08 Aug 90

as rescinded by SOP Nr 01 GHQ, AFP dtd 20 Jan 2004.

b. Purpose. The Standing Operating Procedures establishes the policies and procedures on the designation of positions of Chiefs of Technical Services in the Major Services and GHQ Post Units / AFPWSSU’s.

c. Policies.

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1) Designation of Technical Service Officers as Chief to the following positions of the Major Services and GHQ Post Units/ AFPWSSUs is subject to clearance/ approval of the Chief of Staff, AFP through the Major Service Commanders and Chiefs of Technical Service at GHQ post units / AFPWSSUs.

(a) Philippine Army

(1) The Army Chief Surgeon (2) The Army Dental Surgeon (3) The Army Chief Nurse (4) The Army Chief Chaplain (5) The Army Judge Advocate

(b) Philippine Navy

(1) The Chief Surgeon Navy (2) The Naval Dental Surgeon (3) The Chief Nurse Navy (4) The Chief Chaplain Navy (5) The Naval Judge Advocate

(c) Philippine Air Force

(1) The Chief Surgeon, Air Force (2) The Chief Dental, Air Force (3) The Chief Nurse, Air Force (4) The Chief Chaplain, Air Force (5) The Chief Air Judge Advocate

(d) GHQ Post Unit’s/AFPWSSU’s

(1) The Commanding Officer, CGEASH (2) The Command Chaplain Service, CGEA (3) The Commanding Officer, CGEA Dental

Dispensary (4) The Command Nurse, AFPMC (5) The Command Judge Advocate (6) The Commanding Officer, AFPMC (7) The Commanding Officer, AFP Dental

Service (8) The Command Chaplain, AFPMC (9) The Chief Nurse, PMA (10) The Command Judge Advocate General,

PMA (11) The Command Chaplain, PMA (12) The Chief Nurse, PSG (13) The Command Judge Advocate General, PSG (14) The Command Dental Surgeon, PSG

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(15) The Command Chaplain, PSG

2) Commanders of Major Services and TDCS for GHQ Post Units/ AFPWSSUs, may designate an officer in an OIC capacity to any position listed under para 3a if exigency of the service arises while waiting for the approval/ clearance of the Chief of Staff, AFP.

3) Designation of all chiefs of personnel, technical and

special staffs at GHQ, AFP is subject to approval by CSAFP.

d. Procedures.

1) At least sixty (60) days to the projected relief or transfer of the aforementioned officers, concerned Chiefs of Technical Services, shall submit the names of one (1) principal and two (2) alternate candidates for the positions in para 3a above.

2) Candidates for Chief of Technical Service Officers in the Major Services and GHQ Post / AFPWSSUs shall be recommended by the Chief, Technical Service concerned in consultation with the CGs and commanders of Major Service taking into consideration the continuing professionalization of the Technical Service Officer Corps, the career development of Technical Service Officers and the needs of the cognizant commands/ unit. In case of non-concurrence between the two recommending authorities, separate recommendations may be forwarded to the Chief of Staff for final decision.

3) For GHQ Post Units / AFPWSSUs, the same procedure applies as in the above paragraphs except that coordination is made with DCS for Personnel, J1.

4) Recommendation shall be fully justified and shall include SOI and brief narrative career profile of the recommendees. This recommendation shall be submitted to the Chief of Staff, AFP (Attn. DCS PERS, JI). on the recommendation for positions in para 3a for subsequent approval by CSAFP.

5) The Technical and Administrative Service BOSO (T/AS BOSO) should pass on the recommendation for positions in para 3a for subsequent approval by CSAFP.

Section 3-3 Extension of Tour of Active Duty/ Retention of Nurse Corps

Officers

8. General. The Army Chief Nurse shall recommend the ETAD of NC officers assigned PA. Orders of ETAD will be issued at GHQ level. Likewise, reversion to inactive status of NC officers’ assigned PA shall be

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recommended by the Army Chief Nurse thru channel to The Chief Nurse, AFP. The NC Officer for ETAD shall submit the following requirements.

a. Commander's recommendation (Division or equivalent) b. Personnel Action Form

c. Summary of Information

d. OERs for the last three (3) years

e. CAD Orders

f. Last ET AD Orders

g. Statement of Service (OTAG, AFP)

h. Annual Physical Examination

i. Physical Fitness Test

j. Worksheet (with over-all rating)

k. Command Clearances

1) GHQ (J2, J6, PEMRAD, TIG, TJAG, TPMG, and OESPA) 2) PA (G2. G6. G6 Mgmt, IG, JAG, PMG, OESPA)

3) DIVISION: (G2, G6, G6 Mgmt" IG, JAG, PMG, OESPA)

Submit requirements in ten (10) folders including the original, and all

reproduced copies must be authenticated.

9. Retention. Section I of Executive Order No. 79, s-86 states that a reserve officer is initially called to active duty for a period of three (3) years. Upon satisfactory completion of his tour of active duty, it shall be extended for a period of another three (3) years.

A Reserve Nurse Corps officer who has rendered six (6) years of continuous active military service shall, upon satisfactory completion of his tour of active duty, be granted another extension for a period of four (4) years.

A Reserve Nurse Corps officer who has satisfactorily rendered ten (10) years of continuous active commissioned military service shall have security of tenure and shall not be reverted to inactive status except upon his own request or for cause as may be adjudged by a court martial or by appropriate bodies existing by provisions of law or by virtue of the operation of PD 1638, as amended which provides for the forced lateral attrition of officers based on exigencies of the service up to the time they reach the compulsory' retirement

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of thirty (30) years of service or fifty six (56) years of age which ever comes later but not later that sixty (60) years of age.

Section 3-4 Promotion of Nurse Corps Officer 10. Promotion Guidelines. NC officer’s candidates for promotion shall be evaluated and passed upon by the appropriate promotion board.

a. Medical Service Selection Board "A" - for promotion to 0-4 and 05

b. Medical Service Selection Board "B" - for promotion to 02 and

03

c. NC officer’s candidates for promotion to 0-6 shall be evaluated and passed upon by the Technical Service Board of Senior Officers and AFP Board of Generals. 11. Qualifications. Officers are qualified for promotion when they have satisfactorily met the minimum time-in-grade, active commissioned service (ASCS) and required career courses.

a. Time in Grade (TIG). The counting of the TIG shall commence from the effective date of the last permanent promotion or appointment to the active service up to the effective date of the contemplated promotion to the next higher permanent grade.

GRADE LENGTH OF SERVICE/TIG REMARKS 02 3 yrs active Commissioned Service both regular and reserve 03 7 yrs active Commissioned Service both regular and reserve 04 2 yrs as O-3 no TIG for Reg 05 2 yrs as O-4 no TIG for Reg 06 3 yrs as O-5 1 yr TIG for Regular

b. For NC Regular officers, the length of service requirement shall

be prescribed by See 6, 7, 8 and 9 of RA 291. c. Nurse Corps Career Courses Requirements. A Nurse Corps

officer for promotion must have satisfactorily completed the required military career courses for promotion to the grades as indicated:

Grade Career Courses

O-3 Technical Service Officers Basic Course

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O-4 and O-5 Technical Service Officers Advance Course

O-6 Command and General Staff Course O-7 MNSA or equivalent Masteral/ Doctorate

Degree

d. Zone of Consideration. A Nurse Corps officer to be eligible for promotion to the next higher grade must have his name within the zone of consideration prescribed.

e. Position Eligibility. A Nurse Corps officer to be eligible for

promotion to the next higher grade must be eligible to the position assignments authorized to that next higher grade.

f. Seniority and Maturity. Pertains to the relative placement of a Nurse Corps officer in the particular promotion.

g. Physical Fitness and Appearance.

h. Professional Preparation

i. Additional Criteria (for 0-6 and 0-7)

1) Qualitative

(a) Physical fitness and ability (b) Professional development

(c) Record of performance

(d) Professional attributes and ethics

(e) Maturity

2) Quantitative

(a) Seniority (b) Geographical assignments

(c) Type of assignments

(d) Troop command or equivalent

(e) Educational attainment

(f) Awards

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(g) Service reputation

(h) Career Courses

(1) Military Courses (2) Non military Courses

(3) Special Courses

j. Addendum.

1) NC officers are disqualified for promotion when they are:

(a) Missing in Action (MIA).

(b) Due for separation for those who are on terminal leave.

(c) Physically and psychologically unfit for military service.

(d) Have been deferred twice for promotion to the next higher rank.

(e) Twice removed by the President from the promotion list.

(f) Removed by the President from the promotion list and not selected by the succeeding board.

(g) Having been deferred once in grade O-1.

(h) Convicted by a court martial whose sentence includes dismissal from the service.

(i) Recommended for lateral attrition.

(j) Separation or dismissal has actually been recommended to the President.

2) NC officers are also disqualified for promotion when they

have administrative impediments such as the following:

(a) Carried in the Morning Report as AWOL

(b) Under arrest or confinement

(c) Those who have escaped arrest or confinement

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(d) Those with pending cases

Section 3-5 Separation of Nurse Corps Officers

12. Termination of Appointments. Appointments of Reserve NC Officers of the AFP are automatically terminated by:

a. Death b. Resignation

c. An approved administrative order d. Court martial decision

d. Physical disability

e. For cause

1) NC officers referred to and found by the AFP Efficiency

and Separation Board not fit for retention because of substandard performance, low potential, doubtful integrity and/or acts Inconsistent with the best interest of the service shall be separated upon approval of the President.

2) NO officer in the grade of O-1 who is deferred once for

promotion or an NC Officer in the grade higher than O-1 below that of O-6 who is deferred twice for promotion to the next higher grade shall be separated.

13. Reversion. A Reserve Nurse Corps officer whose term of active duty has not been extended shall be automatically reverted.

A Reserve Nurse Corps officer reverted to inactive status not for cause nor shall retired, who has completed 4 1/2 years of service receive a reversion gratuity equivalent to one (1) month base pay and longevity pay in the permanent rank held at the time of reversion multiplied by his years of active service. Reserve Nurse Corps officer for reversion shall submit the following requirements.

a. Personnel Action Form b. Basic Request

c. Physical Examination Report

d. Statement of Service from OTAG, GHQ

e. Leave Records from OTAG, GHQ

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f. Certificate of Non-Pending Case, No Money/Property Accountability Unit Clearances/Statement of Last Payment g.

g. Clearances from IGPA, AJAG, PMPA

h. Clearances from SAO, PA; PA Housing Board; NAF, PA; G6 Mgmt; Actg Svc, 06; FCPA;ESB, PA; OESPA, PA

i. Affidavit of Non-Contractual Service with the AFP

j. Affidavit re: Effectively and Non-Revocation of Reversion Orders k Affidavit that Counseling has been done

k. Latest Statement of Assets and Liabilities

l. Ombudsman Clearance

m. Last Promotion Orders

n. Circular No. 19 GHQ AFP Certificate

o. Reproduced Copy of Savings Account Number with LANDBANK of the Philippines near permanent address 14. Retirement. Retirement may either be:

a. Optional - upon accumulation of at least twenty (20) years of satisfactory active service.

b. Compulsory - upon attaining fifty six (56) years of age or upon

accumulation of thirty (30) years of satisfactory active service which ever comes later, but not later than sixty (60) Years of age.

c. Upon death in line of duty with at least twenty (20) years of active military service.

d. Upon incurring permanent disability in line of duty with at least twenty (20) years of active military service.

15. Documentary Requirements for Retirement & Pension/Gratuity Claims (per AFP Personnel Directive Nr 01-05 dtd 2 Jun 05)

a. Personnel Action Form (AFP AGO 110) -with appropriate attachments 2 copies

b. Statement of Service signed by Major Service Adjutant 5 copies

c. Leave Records signed by Major Service Adjutant

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3 copies

d. Major Service Clearance from the following Offices 1 copy each JAGO, Provost Marshal, IG, NAF Housing, OESPA and Accounting

e. Ombudsman Clearance 3 copies f. Retirees Data Sheet 1 copy

With necessary family documents

g. Physical Examination Report (CDD only) h. Photocopy of LBP Savings Passbook Account 2 copies

Branch nearest residence during retirement

Addendum a. LTR Endorsement from Major Service Commander 2 copies b. Statement of Last Payment 3 copies

c. Retirement Order and CG’s approval for EP assign 3 copies

In their respective Major Service Instructions

a. Application for retirement must reach BCD, OTAG NLT 6

months prior to the effective date of retirement. b. Terminal Leave Application must reach BCD, OTAG NLT 3

months prior to the effective date of terminal leave.

c. Photo copies must be duly authenticated.

d. Reason for Action in Personnel Action Form (AGO F110) must specify the following:

1) Type and effective date of retirement. 2) Mode of Payment: 36 months lump sum or direct monthly

pension.

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3) That optional retiree has contractual service or without contractual service.

16. Separation of Regulars NC Officers. A Regular Nurse Corps officer is separated for cause due to misconduct, willful failure, the intemperate use of drugs O' alcoholic liquor and vicious/immoral habits.

Regular Nurse Corps officers who resigns his commission in the Regular Force, May upon recoml1endation of the CS, AFP be appointed in the Reserve Force in the last grade held. Such resignation from the Regular Force and reappointment m the Reserve Force is upon approval by the President and published in appropriate AFP orders.

Section 3-6 Evaluation of Nurse Corps Officers 17. Officer's Appraisal Report. ( Refer to Annex F)

18. Career Development Program for Nurse Corps Officers in the AFP. (Refer to Annex G). 19. Maintenance of Qualification Files. The Army Chief Nurse shall maintain the qualifications file of each PA Nurse Corps Officer assigned or detailed under her technical jurisdiction. These records will be composed of the initial curriculum vitae or classit1cation questionnaires for training details, ratings or evaluation in assignments, reevaluation of AFPOS, orders for AFPOS and subsequent changes thereof. Cover sheet for this file will be the career pattern worksheet.. The Office of the Army Chief Nurse will be provided with a copy of the qualifications file for each Army Nurse Corps officer assigned or detailed under his. Jurisdiction. These records will be composed of the initial curriculum vitae or classification questionnaires for training details, ratings or evaluation in assignments, re-evaluation of AFPOS, orders for AFPOS, and subsequent changed thereof. Cover sheet for this me will be the career pattern worksheet. 20. AFPOS Standards for Nurse Corps Officer. The AFPOS classification for Army Nurse Corps Officers follows the basic AFPOS classification for AFP Nurse Corps Officer on the following Specialty areas.

a. Nursing Service Administration 32A b. Flight Nurse 32B

c. Psychiatric and Mental Health Nurse 32C d. Communicable

Disease Nurse 32D

d. Pediatric Nurse 32E

e. Operating Room Nurse 32F

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f. Orthopedic Nurse 32G

g. Maternal and Child Health Nurse 321

h. Hemodialysis Nurse 32J

i. Neurotically Nurse 32K

j. General Duty Nurse 32L

k. Intensive Care Nurse 32M

l. Oncology Nurse 320

m. Public Health Nurse 32P

n. Nurse Educator 32Q

o. Trauma Nurse 32R

p. Neurosurgical Nurse 328

Officers classified as General Duty Nurse are qualified to perform

various nursing functions in a hospital, infirmary or other military health care facilities, rather than being limited to one particular field. Therefore, these officers pass a diversity of knowledge, skill in the general medical and surgical fields" This AFPOS will not be used as primary or secondary classification when it has been determined that an officer is classified in a specialty field.

The alphabetical prefixes will not be used an the following AFPOS:

a. Flight Nursing b. General Duty Nursing

21. Proficiency Designation.

a. Prefix D - Award of the Prefix "D" indicates ability to' function as Staff Nurse with potentials far growth in a specialty area. It will be awarded to' the following:

1) Officers of varying professional competence who' have

completed a postgraduate course or appropriate studies in the farm of Specialty Training/Formal Course of no' less than six months and have sufficient successful professional practice of at least six months in the specialty areas as fallows: Communicable Disease Nurse (32DD), Pediatric Nurse (32ED),Operating Roam Nurse (32FD),Orthopedic Nurse (32GD), Matermal & Child Health Nurse (32ID), Hemodialysis Nurse (32JD),

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Neurolagical Nurse (32 KB), Intensive Care Nurse (32MD), Neurosurgical Nurse (32SD).

2) Psychiatric and Menm1 Health Nurses (32CD) who have

successfully completed the Nurse Specialty Training Course one (1) year (six (6) months didactic and six (6) months practicum).

3) Officers classified as Flight Nurses (32BD) who have graduated from an approved program of Flight Nurse Corps, who have shown proficiency, and who have completed 100 hours certified flying time in military aircraft while training or performing flight nurse duties. They have been designated Flight Nurses by the Commanding General, Philippine Air Force.

4) Officers classified as Nursing Service Administrators (32AD) or Nurse Educators (32QD) with two (2) years professional experience in an administrative staff position/in an educational institution, have completed nine (9) masteral degree units in Nursing Major in Nursing/Hospital Administration, Nursing Education.

b. Prefix C - The award of the Prefix "C" indicates ability to function as head nurse in the specialties listed in letter a number 1 above or as assistant instructor or in a staff position with administrative judgment in the supervision and development of nursing personnel.

1) Officers qualified as Psychiatric and Mental Health Nurse

(32CC), Communicable Disease Nurse (32DC), Pediatric Nurse (32EC), Operating Room Nurse (32FC), Orthopedic Nurse (32GC), Maternal and Child Health Nurse (32IC), Hemodialysis Nurse (32HC), Neurological Nurse (32KC), Intensive Care Nurse (32MC), Oncology Nurse (320C), Public Health Nurse (32PC), Trauma Nurse (32HC) , Neurosurgical Nurse (32SC); who have a maximum of three (3) years professional experience in their specialty at least one (I) year of which was in the capacity of head nurse or instructor and with fifteen (15) masteral degree units preferably in clinical specialty.

2) Officers classified as Flight Nurse (32BC), who have at

least three (3) years continuous practice in the specialty whose records indicate increase in competence in Flight Nursing, have two hundred (200) certified flying times in a military aircraft while training or performing flight nurse duties.

3) Officers classified as Nursing Service Administrator (32AC) or Nurse Educator (32QC) who completed a minimum of twenty one (21) masteral degree units in Nursing Major in Nursing Administration or Nursing Education or related course as Masters of Hospital Administration. In addition, the officer must have had a minimum of seven (7) years of progressive professional nursing experience and have served in an administrative staff position or in an educational institution for at least three (3) years in a military hospital within the past five (5) years prior to reclassification.

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c. Prefix B - The next award of prefix "B" indicates ability to function as a supervisor capable of developing junior officers. Furthermore, it identifies officers qualified academically and through experience to fill positions as Chief Nurses or Administrative Staff Officers.

1) Officers who completed twenty one (21) masteral degree

units in Nursing preferably Major in the field of specialty listed in letter a, number 1 above, have ten (10) years progressive nursing experience in the specialty with five (5) years as Training Officer, have advance training in field of specialty.

2) Officers classified as Flight Nurse (3288), have been on

cumulative flying status for seven (7) years prior to reclassification, preferably with additional aero medical training as Flight Nurse abroad, whose records indicate increasing competent as Flight Nurse preceptor, who have logged 800 hours certified flying time in military aircrafts while training or performing flight nurse duties, designated Senior Flight Nurse by the Commanding General, Philippine Air Force.

3) Officers classified as Nursing Service Administrators (32AB)/Nurse Educators (32QB) who have a master's degree in Nursing Major in Nursing/Hospital Administration/Education and have a minimum of twelve (12) years progressive professional nursing experience, six (6) years of which are in supervision, training or administration, where they have demonstrated executive leadership qualities and smooth interpersonal relationship among nursing personnel and allied groups. Moreover, the officer must be competent in developing training programs for nurse educators and providing professional growth opportunities for potential Nurse Administrators/Educators.

d. Prefix A - The highest award of prefix "A" indicates outstanding

qualifications in the specialty, evidenced by ability as an instructor, contribution to nursing science through research, professional articles or books published and/or continued demonstration of exceptional professional ability in the particular field.

1) Officers qualifying for the "A" prefix must have a master’s

degree from a recognized educational institution and must have completed the Command and General Staff Course (CGSC) as minimum requirement.

2) Officers classified as Flight Nurses (32BA), have been on

flying status for fifteen (15) cumulative years, have demonstrated the qualities of flight nurses, strategic planner, doctrine developer with exceptional communication and collaborative abilities, have designated Chief Nurse Air Force and Chief Flight Nurse by the Commanding General, Philippine Air Force and have significantly contributed to the advancement of Flight Nursing.

3) Officers classified as Nursing Service Administrators (32AA) /Nurse Educators (32QA), who have twenty (20) years progressive professional experience, ten (10) years in supervision, administration or

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training, have demonstrated excellent executive leadership qualities, smooth interpersonal relations, competent in developing leaders: belonged to the upper 500/0 of the CGSC class, have masters degree in Nursing Major in Nursing Administration or Masters of Hospital Administration.

4) Upon initial Call to Active Duty, Nurse Corps Officers are assigned at AFP Medical Center and classified as General Duty Nurse (32L). 22. Primary AFPOS. Refers to the specialty currently practiced by the Nurse Corps officer. In cases wherein said officer has two simultaneous specialties, decision has to be made by the Army Chief Nurse as to which is the primary and the secondarily AFPOS. Generally, the specialty which is more practiced by the NC officer assumes the level of primary AFPOS while the specialty which is less practiced, is relegated to secondary AFPOS 23. Secondary AFPOS. Refers to the specialty which is not currently practiced by the Nurse Corps officer but wherein he already has received prior proficiency designation. 24. Nurse Corps Career Pattern. Upon initial Call to Active Duty (CAD), Army Nurse Corps officers are assigned at a general/station hospital/ medical infirmary I medical center and designated general duty nurse. 25. Career Courses

a. All newly Called to Active Duty Nurse Corps officers should attend the Technical Service Officers Basic Course preferably within the first year of tour of active duty.

b. Between the 8th to the 12th year, Army NC officers should

attend title Technical Service Officers' Advance Course, local or abroad.

c. Selected Army NC Officers who have shown executive and leadership abilities will attend the Command and General Staff Course local or abroad, preferably between the 16th and 20th year of tour of active duty.

d. NC officers occupying top positions and who have demonstrated exceptional professional ability may attend the Master of National Security Administration Course or its equivalent, local or abroad, preferably on the 21 st year of tour of active duty. 26. Specialty Training/On the Job Training. Specialty Training/On the Job Training is a continuous and on going process for any Army NC officer.

Army Nurse Corps officers who have been on active duty for two (2) years are eligible to apply or may be recommended by the Army Chief Nurse, for specialization training conducted at civilian or military installation, local or abroad. These courses are: Nursing Service Administration; Flight Nursing; Psychiatric and Mental Health Nursing; Communicable Disease Nursing; Orthopedic Nursing; Maternal and Child Health Nursing; Hemodialysis

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Nursing; Neurological Nursing; Intensive Care Nursing; Oncology Nursing; Public Health Nursing; Nursing Education; Trauma Nursing and Neurosurgical Nursing.

27. Assignments. The Nurse Corps Career Pattern (Figure 3-1) depicts the general development and career progression of an Army NC officer brought about through planned and monitored assignment. Although not all officers will receive diversified assignments, all are given opportunities to progress in their chosen field. 28. Career Management. The Nurse Corps career pattern program is designed to develop the utmost potentials of the NC officers. The is facilitated by training them in professional specialties and command and staff functions and by placing them in appropriate duty positions.

Re-evaluation of Army Nurse Corps officer's AFPOS shall be done yearly (every first week of August). This evaluation is done by the Army Chief Nurse or through designated cognizant representative.

A career pattern worksheet shall be prepared for each officer to include all his previous assignments and the plan of his future assignment for the normal career period up to age 56 or 30 years of active service, whichever comes later. 11ris will form the cover sheet of this individual's classification me.

The Chief Nurse, AFP ensures the effective and efficient management of the career development of Nurse Corps officers.

At the end of the basic phase, Army Nurse Corps Officers who failed to achieve the minimum level required, that is, a "C" proficiency in their chosen career pattern, will be retained on such pattern

Requirements for Proficiency Designation in the Specialty Areas

AFPOS CLASSIFICATION

AFPOS CODE

PREFIX D PREFIX D PREFIX D PREFIX D

Nursing Service

Administrator

Nurse Educator

32A

32Q

2 yrs professional

nsg experience, as

distractive/ training staff

9 masteral

degree units MAN major in

Nursing Administration/ Education/ Master of Hospital

Administration

7 yrs progressive professional

nsg experience, 3

yrs as administrative.

Trng staff within past 5 yrs prior to

reclassification 21 master

degree units MAN major in

Nursing Administration


nsg experience, 6

yrs in supervision,

administration training

Demonstrated executive leadership qualities

smooth IPR competent

and


nursing experience,

10 yrs in supervision

administration, training,

Demonstrated outstanding

executive leadership qualities

smooth IPR competence

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/ Education, master of Hospital

Administration.

developing training

programs for future leaders MAN. MHA graduate

in developing leaders,

Upper 50% of SGSC class, MAN. MHA graduate

Flight Nurse 32B FN Crse graduate

Proficient, 100 hrs Certified flying time in

military aircraft while training/ per-forming FN duties. Designated FN by CG,

PAF

3 yrs continuous

flying status, Increasing

competence in Flight Nursing

200 hrs certified flying time in military aircraft while

training/ performing FN

duties

7 yrs cumulative

flying status. Flight Nurse Preceptor. Preferably

with additional

aero-medical trng abroad

500 hrs certified

flyiong time in military

aircraft while trng

performing FN duties. Designated

Senior FN by CG, PAF

15 yrs cumulative flying status FN strategic

planner, doctrine

developer, with

exceptional communicati

ons and collaborative abilities. 800

certified flying time CN, PAF Designated Chief FN by

CG, PAF Significantly

contributed to the

advancement of Flight Nursing

Psychiatric & Mental Health Nurse

32C AFP Nurse Specialty Trng Crse Graduate

6 mos successful

practicum in specialty area

at AFPMC


nursing experience in specialty with 1 yr as HN/

Instructor. 15 masteral

degree units in Nursing

Preferably major in field of specialty


nsg experience in the specialty

with 5 year as trng officer in the specialty.

21 degree units in Nsg preferably

major in field of specialty

Advance Trng in specialty.


nsg experience in the specialty

area. Outstanding qualification

as professional nurse in the specially as

evidenced by ability as trainors,

contribute to nsg science through re-

search, professional

article or books publish

continued demonstration of expect

ional ability in pertinent field Graduate in

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MAN, MHA preferably

major in field of specialty.

Communicable Disease Nurse

32D -do- -do- -do- -do-

Pediatric Nurse 32E -do- -do- -do- -do- Operating room

Nurse 32F -do- -do- -do- -do-

Orthopedic Nurse 32G -do- -do- -do- -do- Maternal & Child

Health Nurse 32I -do- -do- -do- -do-

Hemodialysis Nurse 32J -do- -do- -do- -do- Neorological Nurse 32K -do- -do- -do- -do-

Intensive Nurse 32M -do- -do- -do- -do- Oncology Nurse 32O -do- -do- -do- -do-

Public Health Nurse 32P -do- -do- -do- -do- Trauma Nurse 32R -do- -do- -do- -do-

Neurosurgical Nurse 32S -do- -do- -do- -do-

Section 3-7 Recruitment and Selection of Appointment of PA Nursing

Service Civilian Employees

29. General. The Omnibus Rules Implementing Book V of Executive Order No. 292 as of June 1995 Rule II Section I states that opportunity for government employment in the career service shall be opened to qualified Filipino citizens and positive efforts shall be executed to attract the best qualified to enter on the basis of fitness to perform the duties and assume the responsibilities of the position. The appointing authority shall be guided by the Civil Service Law and Rules. In a11 PA health care facilities the Commanding Officer through the Chief Nurse shall initially screen the applicants. All recommendations shall be submitted through channels. No applicant shall be allowed to work prior to the approval of their application papers by the Department of National Defense and/or attestation by Professional Regulation Commission. Applicants for Nursing Service positions shall pass the Mental Ability Test (MAT) as prescribed in SOP Nr 2 GHQ, AFP dtd 03 October 1969 subject "Qualifying Examinations for Civilian Employees in the AFP." 30. Requirements. The applicant shall be required to accomplish and submit to the appointing authority the following:

a. Personal Data Sheet (CS Form 212). b. Civil Service Eligibility (RA 1080) - for professionals.

c. Transcript of Records.

d. Diploma.

e. Board Rating.

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f. Job Description Form (CS Form 122-d) to be signed by the

Recommending authority.

g. Availability of Funds.

h. Record of physical and medical examinations performed in any available medical installation.

i. Clearances form NBI, Police.

j. ID pictures-4 copies.

k. Basic Request/Letter of Application.

Section 3-8 Management and Utilization of PA Nursing service Civilian Employees

31. Assignment and Utilization. Civilian nurses/midwives/nursing attendants shall be assigned in job8 involving direct and indirect patient care. They shall be under the direct staff supervision of the Chief Nursing Service or NIC of the PA health care facilities where they are assigned and shall be governed by the civil service regulations.

Positions of nursing service civilian employees shall be included in the workload management of any PA health care facility as augmentation/compliment of military personnel. Requirements of such positions are incorporated in the TOE of the installations. The positions shall be classified as permanent, emergency or casual, subject to the existing civil service and current civilian employee’s policies.

Section 3-9 Promotion of PA Nursing Service Civilian Employees 32. Definition. Promotion is the advancement of an employee from one position to another with an increase in duties and responsibilities as authorized by law, and usually accompanied by an increase in salary.

The Omnibus Rules Implementing Book V of EO Nr 292 Rule VI of Aug 1999 states that when a position in the first level becomes vacant, the employee in the Nursing Service who holds a next in rank position that is deemed the most competent and qualified possesses an appropriate Civil Service eligibility, and meets the other conditions for promotion may be promoted. However, the appointing authority may promote an employee who is not next in rank position but possesses superior qualifications and competence compared to a next in rank employee who merely meets the minimum requirements for the position.

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The comparative degree of competence and qualifications of the

Nursing Service personnel shall be determined by the extent to which the employees meet the following requirements at the time of appointment:

a. Performance -- this shall be based on the last performance rating of the employee. However, no employee shall be considered for promotion unless his last two (2) years performance rating is at least Very Satisfactory.

b. Education and Training - these shall include educational background and successful completion of training courses, scholarships, training grants and others. Such education and training must be relevant to the duties of the position to be filled.

c. Experience and Outstanding Accomplishments - these shall include occupational history, work experience and accomplishments worthy of special commendation.

d. Physical Characteristics and Personality traits - these refer to the physical fitness, attitudes and personality traits of the individual which must have a bearing on the position to be filled.

e. Potential- this takes into account the employee's capability not only to perform the duties and assume the responsibilities of the positions to be filled but also those of higher and more responsible positions.

A Selection/Promotion Board shall be established by the Office of the

Asst Chief of Staff for Personnel G1 which shall be responsible for the adoption of a formal screening procedure and formulation of criteria for the evaluation of. Candidates for promotion. The Board shall establish reasonable and valid standards and methods of evaluating the competence and qualification of all employees competing for a particular position. The criteria establish for evaluation of qualification of candidates must suit the job requirements of the position and should be applied fairly and consistently. The Selection/Promotion Board shall maintain records of deliberations which shall be available for inspection by the concerned authority.

The Selection/Promotion Board shall determine en bane the list of employees recommended for promotion and submit to the appointing authority that will choose the employee to be promoted.

Section 3-10 Termination of Employment of PA Nursing Service Civilian

Employees

Nursing Service Civilian Employee assigned in any PA health care facility maybe separated from his employment by resignation, dropping from rolls, dismissal, retirement or by death in accordance with

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a. Resignation - voluntary written notice of the nursing service employee informing the appointing authority that he/she is relinquishing his position and stating the date of such resignation shall take effect.

b. Dropping from the rolls - a civilian Nursing Service employee

who is absent for at least thirty (30) days without approved leave is considered Absence Without Leave (AWOL) and may be dropped from the service without prior notice.

c. Dismissal - involuntary termination from the employment for cause.

d. Retirement - compulsory or optional termination of employment:

1) Compulsory/automatic. at the age of 65 years old if the nursing service personnel has completed fifteen (I5) years of service or after rendering a total service of thirty (30) years.

2) Optional. regardless of age, after rendering at least

twenty (20) years of service and provided the nursing service personnel is physically mentally disabled.

Section 3-11 Evaluation of PA Nursing Service Civilian Employees 33. New Performance Evaluation System. The provisions of Rule IX Section I of EO 292 dated February 14, 1992 which state that "There shall be established performance evaluation systems in every department or agency of the national 3-Dd local government.” The Performance Evaluation System contains the following parts:

a. Objectives b. Basic policies

c. Procedures/ Mechanics of the system d. Mechanics of Rating

All Civilian Nursing Service employees assigned to any PA health care

facility shall be evaluated using the AFP Evaluation System for civilian employees which is est1blished and implemented based on LO 1469. 34. Submission of New Performance Evaluation System. The Army Chief Nurse shall submit regularly the Performance Appraisal Report of all PA Civilian Nursing Service Employees to G 1 on the following dates:

a. Regular and Casual Employees:

1st Semester Report NLT 15 July of each year (1 Jan - 30 Jun)

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2nd Semester Report NLT 15, Jan of each year (1 July - 31 Dee)

b. Contractual Employees:

1 at Quarter Report NLT 15 Apr of each year (1 Jan-31 March)

2nd Quarter Report NLT 15 July 'of each year (1 Apr -30 June)

3rd Quarter Report NLT 15 Oct of each year (1 July - 30 Sep)

4th Quarter Report NLT 15 Jan of each year (1 Oct - 31 Dec)

Section 3-12 Career and Personnel Development of PA Nursing Service Civilian Employees

35. General. As provided for in Omnibus Rules Implementing Book V of EO 292 of Aug 1999, Rule VIII states that all nursing service civilian employees both professional and non-professional are assets or resources to be valued, developed and utilized in the delivery of quality nursing care to all clients admitted in any PA health care facility. Therefore, their development and retention in the service shall be the main concern of the Chief Nursing Service or NIC. The Chief Nursing Service shall establish a continuing program for career and personnel development for all the nursing service civilian employees. It is also the responsibility of the Chief Nursing Service or NIC to create an environment or work climate conducive to the development of employees' skills, talents and values for better service. 36. Career and Development Programs Designed for Civilian Nursing Service Employees:

a. Induction Program - refers to the program for new entrants in government to develop their pride, belonging and commitment to public service.

b. Orientation Program- refers to activities and courses designed to

inform new civilian nursing service employees about the programs, thrusts and operations of the nursing service as well as their duties and responsibilities and benefits.

c. Reorientation Program - refers to courses designed to introduce new duties and responsibilities, new policies and programs to civilian nursing service employees who have been in the service for quite some time.

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d. Professional /Technical/ Scientific Program - refers to

substantial programs in specific professional/ technical / scientific areas for enhancement of skills and knowledge of second level personnel in the career service.

e. Employee Development Program - refers to courses aimed at maintaining a high level of competence on basic workplace skills among employees in the first level in the career service.

f. Middle Management Development Program - refers to a set or series of planned human resource interventions and training courses to provide senior professional nursing service employees and other employees of comparable ranks with management and administrative skills and to prepare them for greater responsibilities.

g. Value Development Program - refers to courses which are designed to enhance and harness the public service values of the civilian nursing service employees to become effective care givers.

h. Pre-retirement Program - refers to courses which are intended to familiarize would be retirees on the government retirement plans and benefits as well as available business opportunities or other productive options/ pursuits.

i. Executive Development Program - refers to activities and experiences and continuing education intended to enhance the managerial skills of senior professional nursing service employees who belong to the third level.

Section 3-13 Morale and Welfare

37. Benefits and Privileges.

a. In accordance with AFPRG-271 GHQ AFP dtd 25 Sep 87, Military Personnel are entitled to avail the following leaves:

1) Vacation and/or sick leave may be granted to military

personnel after six months of continuous and satisfactory service on the basis of fifteen (15) days vacation leave and fifteen (15) days sick leave for each year of service. Vacation/ sick leave shall be cumulative and any part thereof not taken within the calendar year in which earned, is caused over the succeeding year. Military personnel can accumulate vacation and sick leave credits in excess of ten (10) months of such leave credit.

2) Matemi1y Leave - married female military personnel shall

be entitled to two (2 months maternity leave absence with full pay if they have rendered at least two (2) years of continuous active or half pay if they have

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rendered less than two (2) years of continuous active service. Matemi1y leave shall not be chargeable against accumulated vacation and sick leave.

3) Convalescent Leave - authorized absence of military personnel recovering from sickness or disability considered a part of hospital's treatment and not chargeable against leave of military personnel. It is authorized by special orders issued by AFPMC or General/Station hospitals for a period not exceeding (15) days.

4) Compassionate Leave - this is granted to military personnel confined in military hospitals to allow them to spend the rest of their remaining days with their families at home after they have been declared beyond recovery by hospital authorities. Commanders of APF hospitals who are convinced that these sick military personnel may not live longer than two (2) months, or unit commanders upon certification of an AFP Medical Officer/Director of a civilian hospital, may authorize a compassionate leave upon the request of the client or his next of kin. This leave shall not exceed two (2) months and shall not be charged against the accumulated vacation and sick leaves of the client.

5) Academic leave - granted to all military personnel on formal study leave grant in an institution of learning without charging the said leave against the vacation leave they have earned.

6) Paternity leave - granted to a married male military personnel to be able to attend to the needs of his legal wife after childbirth/ miscarriage not to exceed fifteen (15) days inclusive Saturdays, Sundays and Holidays.

7) Leave to be spent abroad -- a military person may enjoy leave to be spent abroad upon approval by the Secretary of National Defense for a maximum of forty five (45) clays. The following are the Requirements for leave to be spent abroad:

1) Personnel Action Form/Recommendation from the unit (Indicate effective date of leave and specify the address abroad while on leave)

2) Updated leave records

3) Certification that the applicant will not request for

separation/reversion while abroad.

4) Certification that no expense on the part of the government will be involved.

5) Certificate of Non-pending Case from the unit.

6) Affidavit that the applicant has enough funds to support himself and to purchase a round trip ticket for his travel.

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7) Command Clearance, DCS Intelligence clearance,

J2, AJAG, APM. AIG, G6. G6 Mgmt., Finance, PHS)

Application must be submitted to the CG, PA (Attn: G 1 PA Mowel Br) forty five (45) days prior to the affectivity. and must be placed in one (1) long folder with fastener, four (4) copies each and with index tabulation. Approving authority for 0-6- down, CG PA, for 0-7 GHQ.

b. Medical/Dental Services Active military personnel and their

direct dependents and member of CAFGUs can avail of the free hospitalization benefits provided by the AFP health facilities situated in various parts of the country. These benefits include the following:

1) Dispensary or Outpatient Service; 2) Hospitalization (professional services, medicine and

medical supplies)

3) Ambulance Service

4) Dental benefits are also given to military personnel and their dependents. Active military personnel and their beneficiaries are entitled to free dental treatment or services which may range from tooth extraction to dentures.

5) Health Insurance.

(a) National Health Insurance Program/Philippine Health Insurance Corporation. Republic Act 7875 or the National Health Insurance Act of 1995 enacted on 14 Feb 1995 provides for a National Health Insurance Program (NHIP) for all Filipinos. The NHIP replaced the MEDICARE Program to provide insurance coverage to all Filipinos within 15 years. It also ensures comprehensive and effective health insurance coverage and unifies the MEDICARE programs of GSIS, PMCC-SSS and OWWA. The NHIP likewise provides cost-containment and anti-fraud mechanisms to safeguard the health Insurance Fund. Republic Act further established the Philippine Health Insurance Corporation or the PHIC that automatically covered AFP Personnel.

(b) Comparison between the NHIP and MEDICARE.

(1) The NHIP is being handled by one agency,

the Philippine Health Insurance Corporation (PHILHEALTH) while MEDICARE is being handled by four agencies which are the PMCC-SSS for private employees, GSIS for government workers and OWWA for overseas workers.

(2) The NHIP The NHIP package covers a wider range of benefits and services not catered by MEDICARE that includes Emergency Transfer Services and other cost-effective mechanisms.

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(3) The NHIP covers all Filipinos while the

MEDICARE is limited to the four (4) types of beneficiaries as enumerated in item 1 above.

(4) The NHIP requires payment of 3 months contribution within six (6) months before hospitalization while MEDICARE requires three (3) months payment of monthly contribution within one (1) year prior to hospitalization.

(5) The NHIP includes Doctors, Nurses, Midwives and other medical professionals as service providers while the MEDICARE is limited to doctors only.

(c) NHIP Membership. All members of the MEDICARE program are automatically members of the NHIP and are the following:

(1) SSS members (currently employed, self-employed, voluntary and retirees 60 years old and above and have paid the minimum 120 monthly contributions) and their dependents.

(2) GSIS members (permanent, casual,

temporary, pensioners and retirees 60 years old and above and have paid the minimum 120 monthly contributions) and their dependents.

(3) OWWA members and their dependents.

(4) Uniformed personnel of the Armed Forces of the Philippines (AFP), Philippine National Police (PNP), Bureau of Fire Protection (BFP) and Bureau of jail Management and Penology (BJMP) and their dependents.

(5) Indigent members enrolled under the Indigent Program and their dependents.

(d) MEDICARE Benefits provided by the NHIP

(1) Room and Board- the member is allocated 45 days room and board for a year and additional 45 days intended for his/ her dependents.

(2) Medicines with prescription- a prescribed

amount is set by the NHIP to pay medicines incurred by the hospitalized member or his dependents. If the amount is less than the prescribed limit, the NHIP will pay for it but if it exceeds the limit, the member will shoulder the excess amount.

(3) Diagnostic, laboratory and other medical requirements- just like medicines there is also a prescribed amount that NHIP

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will shoulder intended for other hospital expenses for each confinement period.

(4) Professional Fees- For a member to avail of this benefit, he/she must ensure that the attending doctor/physician must be accredited with the Phil Health. No benefits will be given to the member if the attending physician is not accredited with the Phil Health.

(5) Other hospital facilities

(6) Surgical Family Planning Procedure – Surgical procedures such as Vasectomy and Tubal Ligation is provided only to the member and his/ her spouse.

(7) Outpatient Care Treatment – Some outpatient care treatment supported by the NHIP are the following:

• Hemodialysis • Radiotherapy • Chemotherapy • Surgical Operations

(e) Pre-requisites for MEDICARE benefits

(1) The hospital must be accredited with the

PHILHEALTH. In an emergency case where the member gets confined in a non-accredited hospital, MEDICARE Benefits can still be availed provided it is licensed by the Department of Health (DOH)

(2) The member has paid the minimum three

(3) months contribution within six (6) months before confinement. For pensioners or retirees whose age are 60 years and above, a certification from the employer that he/ she has paid the minimum 120 months contribution is enough.

(3) The member/ dependent is admitted because of sickness that needs confinement in a hospital.

(4) The 45 days hospitalization benefit provided for the member is not yet exhausted. The same is true with the 45 days hospitalization benefit for the member’s dependents.

(f) Conditions for non-payment by the NHIP

(1) Medicines without doctor’s prescription (2) Outpatient psychotherapy or counseling for

mental disorders

(3) Drug/ alcohol rehabilitation

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(4) Cosmetic surgery

(5) Home and rehabilitation services

(6) Optometric services

(7) Normal delivery

(g) Others

(1) A member can file his/her claim with the PHILHEALTH within 120 days after discharge from the hospital.

(2) Processing of claims is within 60 days.

Claims can also processed at the Regional Health Insurance Offices (RHIOS).

c. Housing Benefits.

1) On Base Housing. Major Service/Unit Housing Boards assign quarters to Officers and enlisted personnel subject to the following criteria:

(a) For eligibility. Any married military personnel in the

active service, who is head of the family, to include military personnel who are widows/widowers but heads of their families.

(b) For priorities. Priorities in the assignment of

quarters shall be the responsibility of the Major Service Commanders through their MSHB subject to the following order: seniority, maximum presence and date of application.

(c) In the assignment of quarters, the Post Commander shall consider the grade of the applicant. Except for officers entitled to a positional quarters, no military personnel shall be allowed to occupy more than one Officer/EP quarters regardless of location.

(d) The rental of military quarters is equal to the quarter’s allowance of the occupants.

2) Off Base Housing. The overall administration of all AFP

Off-Base housing projects shall be the responsibility of the Chief of Staff, AFP. In carrying out this responsibility, he shall be assisted by the AFP Housing Board which shall oversee the entire AFP Off-Base Housing Program. The Office of the Chief, Special Service through its Housing Development Division shall process, evaluate and recommend for approval to the Chief of Staff, AFP the awarding of Off-Base housing units to qualified occupants. Awarding of housing units shall be order of priority as follows:

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(a) 1st Priority. Married military personnel including widow, widower, separated or divorced in the active service who have no house or lot of their own.

(b) 2nd Priority. Single military personnel in the active

service but head of the family who have no house or lot of their own.

(c) 3rd Priority. Retired married military personnel who have no house or lot of their own.

(d) 4th Priority. Married civilian personnel of the AFP who have no house or lot of their own.

(e) 5th Priority. Married military personnel in the active service who already own a real state property.

(f) 6th Priority. Single military and civilian personnel of the AFP who have no house and lot of their own.

The Housing Development Division shall utilize the financing capacity of the AFPMBAI, AFPSLAI and PAG-IBIG for Off-Base Housing projects.

d. Educational Benefits.

1) The Army Nurse Corps officer is privileged under the 22k

NDA Program at local civilian college or universities on full time or on part time basis.

2) The Army Nurse Corps Officer is also privileged to

undergo foreign military training.

3) Under PD Number 577 dated 11 Nov 1974 educational benefits are extended for dependents of deceased/ incapacitated military personnel in line of duty in the form of payment of tuition/matriculation fees in public schools, colleges, universities and other duly recognized educational institutions.

e. Pay and Allowances

1) Base and Longevity Pays. As per Executive Order Nr 688

dtd 01 March 1981, military personnel are entitled to receive base and longevity pay. Base pay is according to grade.

Longevity pay is equivalent to ten percent (10%) of the

monthly base pay compounded every five (5) years of active and meritorious military service up to a maximum of 50% of monthly base pay.

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2) Incentive Pay. As per RA 3093 dtd 12 Jun 1961 and RA 5338 dtd 15 June. 1968, Nurse Corps officers are entitled to receive incentive pay (IP).

3) Quarters' Allowances. As per Executive Order 262

implemented by GO Nr 10 dtd October 1972 all military personnel are entitled to receive quarters allowance. Quarters allowance is according to grade.

4) Clothing Allowance. As per Cir Nr 5 dtd 8 Feb 1990. EO 755 dtd 21 Dec 81 as amended by EO 1003 dtd 25 Jan 85 further amended by EO 1977 dtd 2 Dec 86, military personnel are entitled to receive clothing allowance.

5) Winter Clothing Allowance As per Cir Nr 17 dtd 13 Aug

1990, military personnel assigned or detailed in temperate countries outside the territorial limits of the Philippines are entitled to receive winter clothing allowance.

6) Cold Weather Allowance As per Cir Nr 17 dtd 13 Aug 1990, military personnel assigned or on detached service (DS) and actually performing duties in cold places within the country are entitled to receive cold weather allowance.

7) Per diems/travel allowance As per Presidential Degree (PD) 344 dated November 1974 military personnel are entitled to receive per diems/travel allowance.

8) Combat Pay As per Cir Nr 7 dtd 23 Oct 1985, all military personnel assigned in the fields are entitled to receive combat pay.

9) Hazardous Pay As per EO Nr 131 dtd 24 May 1968, military personnel who are handling/exposed to hazardous or radiation/radioactive materials such as those assigned to X-ray Dept. Nuclear Medicine Dept and even those handling anesthetic agents are entitled to receive hazardous pay.

10) Living and Subsistence Allowances As per EO Nr 257 dtd 25 July 1997, all military personnel are entitled to receive these allowances.

11) Magna Carta. As per DND Circular Number 20 dtd 09 December 1994, all Military Health Workers of the Department of National Defense are entitled to receive this allowance.

12) Productivity Pay. Monetary compensation based on the performance rating of the military personnel as per National Budget Circular Number 426 dtd 11 April 1992.

13) Thirteenth Month Pay Additional monetary compensation given to military personnel as per National Compensation Circular Number 73 dtd 27 December 1974.

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f. Rest and Recreation (R & R). Army Nurse Corps officers are

entitled to go on rest and recreation from a combat duty assignment.

g. Athletic and Sports Development - the different athletic and sports facilities found in the military installations such as Pelota Court, Tennis Court, Swimming pool, Gym and others can be availed of by military personnel subject to unit regulations.

h. Commissary Privileges - Army Nurse Corps Officers could avail

of commissary privileges, such as to purchase tax free items from a Post Exchange commissary inside the camp.

i. Transportation Facilities. Service. Cars/jeeps are being used by

Chief of Offices and buses that shuttle military personnel within the camp radius. Army Nurse Corps officers are authorized free transportation either military/civilian water, land or air transportation during official function/missions/R & R.

j. Officer's Clubhouse. Army Nurse Corps officers can avail of the

Officers' club and its services subject to the club regulations.

k. Retirement and Separation Benefits.

1) PD 1638 and PD 16.50 are the references for payment of separation and retirement benefits.

2) An Army Nurse Corps Officer covered under the

provisions of PD 1638 on retirement shall be retired in the grade next higher than the permanent grade last held for purpose of pension.

3) If on date of separation an Army Nurse Corps officer who has completed three (3) or more years but less than ten (10) years of active service, be honorably discharged in the permanent grade then he will get a separation pay equal to three (3) months base pay and longevity pay computed on such grade.

4) If on date of separation, an Army Nurse Corps Officer

who has completed ten (10) or more years but less than twenty (20) years of active service, be honorably discharged in the permanent grade then held will receive separation pay equal to one (1) month base pay and longevity pay for each year of active service computed upon such grade (RA 340 Title II Sec 8).

l. Financial Assistance. For the past years, several financial packages have been prepared for the soldiers while they are still in the active service. Listed below are different kinds of financial assistance and the institutions offering these privileges

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1) Salary Loans.

(a) AFPSLAI. Any member can avail of salary loan featuring the No Front Ending (NFE) scheme. Under this scheme, members receive in full the amount he borrows, since no amount is deducted in advance. Instead, the loan payment becomes lighter as the monthly interest is based on the diminishing balance. The salary loan ceiling has likewise been raised to P200, 000.00 and term extended up to five (5) years subject to the Net Take Home Pay policy.

(b) Air Materiel Wing Savings & Loan Association Inc

(AMWSLAI) member can acquire a salary loan equivalent to gross pay times twelve at 11% interest rate per annum.

(c) Philippine Army Finance Center Producers Integrated Cooperative (PAFCPIC) new members are entitled to acquire P15, 000.00 salary loans while old members are entitled to P50, 000.00 at 12% per annum.

(d) Philippine Navy Savings & Loan Association Inc (PNSLAI) members are entitled to acquire salary loan equivalent to twelve times the gross pay at interest rate of 12.5% per annum.

(e) PAG-IBIG members are entitled to acquire a Multi-Purpose Loan (MPL). For eligibility, a member borrower must have made at least 24 monthly contributions and is a contributing member upon loan application. Loan interest is 10.75% per annum while the amortization period is 24 months.

2) Policy Loans.

MBAI - A policy loan is granted to a holder of an

endowment plan on the sole security of a policy contract which has been enforce at least one year at interest rate of 6% per annum.

3) Business Loans.

AFPSLAI – Commercial, Industrial and Agricultural loans. For enterprising regular members, the association offers collateralized loan of as much as P5M payable in 3-5 years through salary deduction and direct payment through post dated checks. The interest rate varies from 16.47% to 19.13% per annum.

4) Housing Loans.

(a) AFPMBAI – Interested members who may want to have a house and lot of their own may now avail of any of the two housing loan that MBAI is currently offering. These are the Real Estate Housing Loan and the Real Estate Mortgage Loan. The maximum loanable amount is P500, 000.00 with interest rate as follows:

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Loan Amount Interest (p.a)

Up to P150, 000.00 9% Over P150, 000.00 to P225, 000.00 12% Over P225, 000.00 16%

(b) AFPSLAI – Members who would like to go into

commercial, agricultural and industrial ventures but are limited by the maximum salary loan limit have an option through the real estate collaterized loan.

(c) PAG-IBIG – the housing loan can be used for the

following purposes:

1) Purchase of residential unit. 2) Construction or completion of a residential

unit on a lot owned by the member borrower.

3) Purchase a lot and construction of a house thereon.

4) Home improvement

A member is entitled to a maximum loan

amount which shall not exceed: Fifty times (50x) the member’s Monthly

Compensation, for employees with employer’s counterpart, whether the counterpart is shouldered by the member or his/her employer, or;

Twenty-five times (25x) the member’s

Monthly Compensation, for employees without employer’s counterpart. The maximum loan amount is P500, 000.00

5) Savings.

AFP military personnel are entitled to opportunities

to save part of their salaries/allowances through the assistance of the following institutions:

(a) AFPSLAI

(1) Capital Contribution Semi-Annually – this account aims to establish membership and for members and for members to deposit funds for at least one calendar quarter at 20% yield per year tax free.

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(2) Savings Deposit - a minimum balance of 100.00 is required. Gives an interest rate of 6% per annum tax free.

(3) Special Savings Account – a minimum placement of P20, 000.00 for 30 days is required. Gives an interest rate of 1% - 2% higher than the prevailing Treasury bill rates and requires no documentary stamps.

(4) For particulars, members can inquire from the nearest AFPSLAI Branch.

(b) PAFCPIC

(1) Capital Contribution (2) Savings Deposit

(3) Time Deposit

(c) AMWSLAI


(3) Time Deposit

(d) PNSLAI


(3) Time Deposit

(e) PAG-IBIG

The member’s contribution, which is

equivalent to 2% of his base pay is doubled by his employer’s contribution and his employer’s counterpart earned fixed dividends of 7.5% per annum, plus variable dividend in case of surplus earning by the Fund.

6) Insurance. Insurance benefits and privileges for AFP personnel are granted by the following institutions:

(a) AFPMBAI

(1) Automatic Insurance

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• With policy loan at 6% interest per annum

• With cash value • With disability benefit • With death benefit

Rank Amount of Insurance Monthly

LTC/Cdr/Supt up P85, 600.00

P60.00

2LT/Ens/Insp to MAJ/ Ltcdr/ CInsp

P71, 400.00

P50.00

Sgt/PO3/SPO1 to CMS/CMPO/SPO4

P42, 800.00

P30.00

Cpl/SN1/PO3 down

P35, 700.00

P25.00

(2) Special Group Term Insurance (SGTI)

• P16, 000.00 coverage on all regular

members • With maximum of P15, 000.00

disability benefit • With additional benefit of )16, 000.00

if killed in action • With additional P1, 000.00 funeral

benefit

(3) Members Educational Assistance Loan (MEDAL)

• Maximum of P50, 000.00 • 7% interest per annum • Payable within 1 year • Loan beneficiaries could be anyone

the borrower designates

(4) Endowment at Age 56

• A life insurance savings and investment plan for members 56 years and below.

• With salary loan at 8% interest per annum

• With policy loan after 2 years it is enforce at 6% interest per annum

• With permanent disability benefits due to accident, military, police or related operations.

• Double insurance benefit in case of accidental death

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• With maturity benefit upon reaching age 56 given in lump sum or on staggered basis for 3 years while waiting for the pension

• With funeral benefit of P10, 000.00

(5) Other additional/optional insurance

• Endowment at 10, 15, 20 years • Anticipated 20 year Endowment

(b) AFPGIC

(1) Fire Insurance. Building, office furniture, equipment and residential building and their contents can be covered against loss/damage by fire, lightning and consequential losses thereof and allied perils in conjunction with ordinary fire coverage.

(2) Motor Car Insurance. Private cars,

commercial vehicles and motorcycles can be insured in combination of property, public liability and personal accident covers.

(3) Marine Insurance. Goods merchandise or movables can be covered against damage or loss caused by the perils of the sea while in transit.

(4) Aviation Insurance. Can be insured against damage or loss from whatever cause while the aircraft is in flight, taxiing, aground or moored. The company shall be liable to pay for accidental property damage if such is caused directly by the impact of the aircraft including articles dropped there from.

(5) Engineering Insurance. Building under construction, civil engineering projects whose construction are in progress, materials, plants and other items in the construction site can be insured against loss or damage caused by specified perils and bad workmanship.

(6) Bonds. GIC caters to the bonding need of its members, it can guarantee the performance of contractual and legal obligation of a third party

(7) Personal Accident Insurance 7) Educational Assistance. Active military personnel and

qualified dependents of active, deceased and retired military personnel are also entitled to educational assistance under the following programs.

(a) AFP Provident Trust Fund:

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(1) AFPPTF Educational Assistance Program – awarded to qualified and deserving dependents of deceased, retired or active AFP military personnel in any of the following educational levels with the indicated amount of support per school year and corresponding duration:

For dependents of deceased/disabled AFP members:

Level Amount College/Vocational 8,000.00/yr High School 3,000.00/yr Elementary 2,000.00/yr

For dependents of active and retired AFP members: Level Amount College/Vocational 5,000.00/yr

High School 2,000.00/yr Elementary 1,000.00/yr

(2) AFPPTF Special Projects – Educational

Assistance Program for military personnel in the active service who plan to pursue studies leading to the degree of Bachelor of Laws (LLB) or Bachelor of Science in Engineering. Grantees must take the required full load of subject to receive a stipend of P4, 000.00 per semester. Bar reviewers receive an allocation of P8, 000.00 and P6, 000.00 respectively.

(b) MOA between CHED and DND/AFP for bright

sons/daughters of EP. This agreement provides children active enlisted personnel (and of those who die or become incapacitated in line of duty) who have excellent academic performance, scholarships in various educational disciplines with degrees such as Engineering, Psychology, Statistics, Medical Technology, Electronics, Computer Science, Economics, Agriculture, Fisheries and Teacher Education major in Math, Science or Language.

(c) The AFP – MERALCO Foundation Inc (MFI) Scholarship Program. The AFP-MFI through the bayanihan Alay Sa Anak Bayani (BASAB) offers scholarship to qualified dependents of military personnel who were killed or wounded in action against local communist and secessionist rebels as well as other lawless groups. The scholarship allows grantees to take up the three-year industrial technology course with specialization in Electrical, Electronics, Instrumentation & Process Control and Tool & Dye Technologies.

Interested applicants may file their application at the office of AFP Educational Benefit Office (AFPEBSO) located at Gate 6, LOGCOM Area, Cp Aguinaldo, Quezon City.

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(d) AFP – UA & P Scholarship Program. The AFP-UA & P Scholarship Program was created under a Memorandum of Agreement between the Armed Forces of the Philippines and the University of Asia and the Pacific with offices located at the school of Management, 6th Floor, APEC Communication Bldg., UA&P Campus, Ortigas Center, Pasig City. The program received initial fund of P4M from former PJEE for the scholarship of AFP Officers and dependents of Enlisted Personnel and to raise additional funds through donations, sponsorship and other fund raising activities to build up and sustain the program.

The program allows qualified senior officers

to take up M.S. in Strategic Business Economics Program and qualified EP dependents to take up Bachelor of Science in Entrepreneurial Management at the University of Asia & the Pacific.

Requirements:

• For the M.S. SBEP – Officers must have a

rank of LTC or higher and pass the criteria imposed by the AFP-UA&P Board. • For the B.S. EM – Dependents must have

high scholastic grades and pass other requirements imposed by the AFP-UA&P Scholarship Board.

8) Rice Allowance. Soldiers assigned on combat duty in

Mindanao are entitled to received one (1) sack of rice monthly from the National Food Authority as contained in the provisions of Executive Order No.88 dated 5 April 1999 Subject: Granting Rice Allowance to Soldiers on Combat Duty in Mindanao.

(a) Tax Exemption for the members of the Armed

Forces of the Philippines. (Ref: Republic Act No 9040 dtd 22 Mar 2001)

An act exempting from tax certain allowances and benefits granted to the members of the Armed Forces of the Philippines. The law provides tax exemption on the AFP personnel’s collateral and collateral allowances, as well as other benefits as provided by law.

The following Pay and Allowances of AFP

personnel shall not be included in the gross income and shall be exempt from taxation:

(1) Longevity Pay (2) Mandatory Allowances – such as Cost of

Living Allowance (COLA) Personnel Economic Relief Allowance (PERA) and Hazardous Allowance.

(3) Collateral Pay – such as Specialist Pay, Combat Pay, Flying Pay, Air Mechanic Pay, Sea Duty Pay, Parachutist Pay and Hardship Pay.

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(4) Collateral Allowances – such as Special

Clothing Allowance, Cold Winters Clothing Allowance, Cold Weather Clothing Maintenance Allowance, Initial Enlistment/Reenlistment Allowance and Laundry Allowance.

(5) Retirement Benefits, Pensions, Death and Disability Benefits.

(6) Exemption from Attachment, Levy and Execution. 38. Nursing Service Civilian Employee’s Benefits

a. Leaves. All nursing service employees assigned in any PA Health Care Facility are entitled to vacation and sick leave credits as well as special leave privileges (Amended by CSC MC Nr 41, section 1998 and 14, s 1999).

1) Vacation and Sick Leaves. Officials/ employees of the

government are entitled fifteen (15) days vacation leave of absence with full pay exclusive of Saturdays, Sundays and Holidays for each calendar year of service and fifteen (1.5) days sick leave for each calendar year of service with full pay exclusive Saturdays, Sundays and Holidays. All officials and employees with ten (10) days or more vacation leave credits shall be required to go on vacation leave whether continuous or intermittent for a minimum of five (5) working days (mandatory leave). Mandatory annual five (5) days vacation leave shall be forfeited if not taken during the year.

However, in cases when the scheduled mandatory

leave has been cancelled in the exigency of the service by the Chief Nursing Service, the scheduled leave not enjoyed shall no longer be deducted from the total accumulated vacation leave. Those with accumulated vacation leave of less than ten (10) days shall have the option to go on forced mandatory leave or not. However, official’s employees with accumulated vacation leave of fifteen (15) days who availed of monetization for ten (10) days, hereof shall still be required to go on forced leave. Hospital employees, whose work schedules are irregular and at times include Saturdays, Sundays and legal holidays and are instead off duty on other days, their off duty days regardless or whether they fall on Saturdays, Sundays or holidays during the period of their leave are to be excluded in the computation of vacation and sick leaves. In other words, if an employee is off duty, say for two (2) days falling on Saturdays, Sundays, or holidays, these days occurring within the period of authorized leave are to be excluded in the deduction of the number of days of leave from the earned leave credits of the employee.

(a) Application for Vacation Leave. All applications for vacation leave of absence for one (1) full day or more shall be submitted by the concerned officially employee on the prescribed form for action by the

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proper head of agency five days (5) days in advance whenever possible of the effective date of such leave.

(b) Approval of Vacation Leave. Leave of absence for

any reason other than illness of an official or employee or of any member of his immediate family must be contingent upon the needs of the service. Hence, the grant of vacation leave shall be at the discretion of the head of agency. Whenever, the application for leave of absence, including terminal leave, is not acted upon by the Chief Nursing Service or his duty authorized representative within five (5) working days after receipt thereof, the application for leave of absence shall be deemed approved.

(c) Application for Sick Leave. All application for sick leave of absence for one (1) full day or more shall be made on the prescribed form and shall be f1led immediately upon employee's return from such leave. Notice of absence, however, should be sent to the immediate supervisor and or to the agency head. Application for such leave in excess of five (5) successive days shall be accompanied by a proper medical certificate. Sick leave may be applied in advance in cases where the officially employee will undergo medical examination or operation or is advised to rest in view of ill health duly supported by a medical certificate.

(d) Approval of Sick Leave. Sick leave shall be granted only on account of sickness or disability on the part of the employee concerned or of any member of his immediate family. Approval of sick leave whether with payor without pay is mandatory provided proof of sickness or disability is attached to the application in accordance with the requirements prescribed. Unreasonable delay in the approval thereof or non approval without justifiable reason shall be a ground for appropriate sanction against the official concerned. When an official/ employee had already exhausted his sick leave credits, he can use his vacation leave credits but not vice versa. Hence an official/ employee who had already exhausted his vacation leave credits cannot use sick leave credits.

2) Maternity Leave - Married women in the government service who have rendered an aggregate of two (2) or more years of service, shall in addition to the vacation leave and sick leave granted them, be entitled to maternity leave of sixty (60) calendar days with full pay. Maternity leave of those who have rendered one (1) year or more but less than two (2) years shall be computed in proportion to their length of service, provided that those who have served for less than one (1) year shall be entitled to sixty (60) days maternity leave with half pay. A married woman may be granted maternity leave more than once a year. Maternity leave shall be granted to female married employees in every instance of pregnancy irrespective of its frequency. (See Annex H)

3) Paternity Leave - Every married male employee is

entitled to paternity leave of seven (7) days for the first four (4) deliveries of his legitimate spouse with whom he is cohabiting. Married male official/ employee with more than one (1) legal spouse shall be entitled to avail of

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paternity leave for an absolute maximum of four (4) deliveries regardless of whichever spouse gives birth. Paternity leave is a non cumulative/non commutative and strictly nOI1- convertible to cash. The same maybe enjoyed either in a continuous or in an intermittent manner by the employee on the days immediately before, during and after the childbirth or miscarriage of his legitimate spouse.

4) Special leaves privileges. In addition to the vacation, sick, maternity and paternity leaves, officials and employees are granted special leave privileges such as:

(a) Personal milestone such as

birthdays/wedding/wedding anniversary celebrations/ death anniversaries; An official/employee can still avail of his birthday or wedding anniversary leaves, if such occasion falls on either a Saturday, Sunday or Holiday either before or after the occasion

(b) Parental obligations such as attendance in school

programs, PTA meetings, graduations, first communions, medical needs where a child of the government official! Employee is involved;

(c) Filial obligations to cover the employee's moral obligations toward his parents and siblings for their medical and social needs.

(d) Domestic emergencies such as sudden absence of a "yaya" or "maid"

(e) Paying taxes, court appearances

(f) Calamity, accident. Hospitalization

Three (3) day limits for a given year shall be strictly observed. An official/employee can avail of one special privilege leave for three (3) days or a combination of any of the leaves for maximum of three (3) days in a given year. Special leave privileges are non-cumulative and strictly non-convertible to cash.

b. Medicare. Medical Care Program (Medicare Act) was

promulgated to make adequate medical care available. The benefits granted under the Medicare Act are:

1) Hospital expenses benefits 2) Surgical expenses / medical expenses (3) Dependents'

benefits

c. Employees Compensation Program

1) Tax exempt compensation program for civilian employees and their dependents created under PD 626 and PD 891

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2) Cash incomes

3) Life and retirement insurances administered by the GSIS

under RA 4968 and RA 1146.

Section 3-14 Awards and Decorations 39. For Military Personnel. This section prescribes the policies, criteria, and administrative instructions concerning granting of awards to deserving persons/unit~/organizations in order to recognize actions or deeds of valor and exceptional service or achievement as per AFP Regulations G-131-053 dtd 1 July 1986; to include its changes 1-4. The objective of awards and decorations is to provide tangible recognition for acts of valor and heroism exceptional and meritorious service or achievement, acts of heroism not involving actual combat, and special skills and qualifications the awards and decorations may be awarded to any personnel or unit/organization either military or civilian, local or foreign, who distinguished himself in outstanding achievement or service in activities relevant to the objectives of the AFP's national security and development.

Recommendation for an award or decoration can be made by the Commanding Officer of an organization, office or unit having knowledge of the deed or act. To be fully effective, an award should be timely. Only one award shall be made for the same act, achievement or service. For each succeeding act, achievement or service that justifies the award of such decoration, same decoration will not be awarded; instead an appurtenance will be awarded. A recommendation for an award based on a period of meritorious service in a given assignment shall not be made while the individual being recommended is still performing or has not been relieved from such assignment. However, if such individual has been performing for the last three (3) years he may be recommended for an award. 40. Decorations

a. Medal of Valor. This is awarded by the President of the Republic of the Philippines to military personnel of the Armed Forces of the Philippines, including recognized guerilla forces. To earn this award, AFP personnel or member of the recognized guerrilla forces must have been involved in actual conflict with armed enemies, distinguishing himself conspicuously by gallantry and intrepidity at the risk of life above and beyond the call of duty. To justify an award of the Medal of Valor, one must perform in action a deed of personal bravery or self-sacrifice above and beyond the call of duty as conspicuous as to distinguish him above his comrades.

b. Distinguished Conduct Star. This is awarded by the Chief of

Staff, AFP to military personnel of the AFP and friendly allied armed forces for conspicuous courage and gallantly in the face of an armed enemy. To warrant

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this award, a person must perform an act of heroism so notable and involving risk of life as extraordinary as to set him apart from his comrades.

c. Distinguished Service Star. This is awarded by the Chief of Staff, AFP to officers of the Armed Forces of the Philippines for eminently meritorious and valuable service rendered in a position of major responsibility. The performance of duty should be exceptional. A superior performance of duties normal to the grade, branch, specialty of assignment, and experience of an individual is not adequate basis for this award. Accordingly, the accomplishment of the duty should have been completed prior to submitting a recommendation, or a person being recommended has been transferred prior to completion, the accomplishment must have progressed to what may clearly be determined to be exceptional or significant.

d. Gold Cross. this is awarded by the Chief of Staff, Armed Forces of the Philippines, Area Commanders and Major Service Commanders to military personnel for gallantry in action not warranting the award of the Distinguished Conduct Star.

e. Outstanding Achievement Medal - this is awarded by the

Secretary of National Defense to military personnel of the AFP and citizens of the Republic of the Philippines, members of the Armed Forces and civilian personages of friendly foreign nations for distinguished or extraordinary achievement or service in the advancement of science or in socio-economic, technical or military fields related to national defense, or for public service of the highest order.

f. Gawad sa Kaunlaran. this is awarded by the Chief of Staff, AFP, Area Commanders and Major Service Commanders to any citizen of the Philippines, for conspicuously meritorious and valuable achievement in the pursuit of socio-economic and other non-combat activities, or for conspicuously exceptional service which contributed immensely in accomplishing the peaceful objectives of the AFP, or in improving the quality of life of the people within the military establishment.

It shall be awarded neither without regard to position held

nor to the duration within which the cited achievement or service is accomplished. Severance from or actual completion of an enterprise is not a consideration; rather, the conspicuity of the achievement is deemed to be end in itself deserving recognition.

g. Bronze Cross. This is awarded by Chief of Staff, AFP,

Commanders of Major Services, AFPWSSU s, Area Commands, Division/Brigade or their equivalent in the PAF and in the PN to military and civilian personnel of the AFP and Armed Forces of friendly foreign nations for heroism not involving actual conflict with an enemy. The performance or acts of heroism must involve risk of life under conditions other than those of conflict with the enemy.

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h. Military Merit Medal. this is awarded by the Chief of Staff, AFP, Area Command and Major Service Commanders, Division and Major Subordinate Unit Commanders with a TO rank of Brigadier General or higher, to military personnel of the AFP for heroic achievement in combat or meritorious achievement for service not involving participation in combat, in connection with military operations against an enemy of the Philippines; for a single act of meritorious service either in a duty responsibility or in direct support of military operations. The required achievement or service for award of MMM is less than that required for award of the DSS; nevertheless, it should be accomplished with distinction. It may be awarded posthumously to members of the AFP, who, while serving in any capacity with the AFP, are killed in action by the enemy of the Philippines, or as a direct result of an act of the enemy.

i. Military Commendation Medal. This is awarded by Commanders of Major Services, Division, Brigade or their equivalent in the PAF and in the PN, AFPWSSUs, and Area Commands to military personnel of the AFP for demonstrated exemplary efficiency, devotion and loyalty to duty assignments. Accordingly, five letters of commendation under one command line are convertible to one MCM.

j. Wounded Personnel Medal. This is awarded to military

personnel of the AFP and civilian citizens of the Philippines serving with the AFP by Commanders of Major Subordinate Units of Major Services down to Battalion Commanders or their equivalent in the PAF and in the PN. In the case of combat patients evacuated to AFP hospitals, the Commanding Officer of AFP hospital is authorized to award this medal.

k. Military Civic Action Medal. This is awarded to military and civilian personnel of the AFP and friendly foreign nations by the Chief of Staff, AFP, Commanders of Major Services, Area Commands, AFPWSSUs, Division/Brigades or their equivalent in the PAF and in the PN.

The award is intended to recognize meritorious

achievement in the field of civic action in duty responsibility or in direct support to military operations.

l. Sagisag ng Ulirang Kawal. This is awarded to military personnel

of the AFP by the Chief of Staff, AFP, and Commanders of Major Services and Area Commands. To earn the award, a military person must have distinguished himself conspicuously in the performance of non-military activates and community development programs and other related activities, which merit public recognition. 41. Service Medals and Ribbons

a. Long Service Medal - this is awarded to military persoill1.el of the AFP by the Chief of Staff, AFP and Major Service Commanders. To earn this award, a military person must have completed 20 years of faithful and

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honorable service with the AFP and for each additional five (5) years, one bronze star shall be affixed to the ribbon.

b. Disaster Relief and Rehabilitation Operation Ribbon - this is

awarded to military personnel of the AFP by the Chief of Staff, AFP, Commanders of Major Services and other units authorized to grant awards, for participation in the rescue, relief and rehabilitation operations connected with typhoons, floods, earthquakes, conflagrations and disaster/calamities for any period during and after said calamities.

c. Anti-Dissidence Campaign Medal & Ribbon - this is awarded to military personnel of the AFP by the Chief of Staff, AFP and Commanders of Major Services. To earn this award, a military person must have participated in the anti-dissidence campaign and operations in any of the aforementioned areas of the Philippines between 30 June 1946 and terminal date to be designated later.

1) Luzon Anti-Dissidence Campaign Medal and Ribbon –

this medal is awarded to military personnel by the Chief of Staff, AFP, Commanders of Major Services and other units authorized to grant awards, for participation from 13 May 1948, in anti-smuggling/piracy and maritime law enforcement in Luzon and the waters immediately adjacent thereto for at least six (6) months; pacification campaign/operations in Luzon or Task Force "Lawin", Isarog:, "Saranay" and Talna" and other Task Forces for at least six months; and for service and paI1icipation from 4 July 1946 in law enforcement, military and civic-action operations in Luzon and waters immediately adjacent thereto for at least six months.

2) Visayas Anti-Dissidence Campaign Medal and Ribbon this medal is awarded to military personnel by the Chief of Staff, AFP, Commanders of Major Services and other units authorized to grant awards. (Annex C4) The award is given to a deserving personnel in anti-smuggling/ piracy and maritime law enforcement operations in the Visayas and the waters adjacent thereto for at least six months, from 8 November 1948; and for his service and participation in law enforcement, military and civic action operations in the islands comprising Visayas for at least six months, from 4 July 1946.

3) Mindanao Anti Dissidence Campaign Medal and Ribbon. this is awarded to members of the AFP by the Chief of Staff, AFP, Commanders of Major Services and other units authorized to grant awards, for participation in the pacification campaign, operation in Lanao and Cotabato and other provinces in Mindanao with Task Forces "LANCAF", " PAGARI" , "PAGKAKAISA", and such other similar Task Forces for a period of at least six (6) months; and for service and participation in law enforcement, military and civic action operations in the islands comprising Mindanao and Sulu and waters immediately adjacent thereto from 4 July 1946 for a period of at least six (6) months. 42. Badges

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a. Philippine Republic Presidential Unit Citation Badge - this is

awarded by the President of the Republic of the Philippines to: c;

1) Any unit of the Armed Forces of the Philippines that distinguished itself with exceptionalloyal1:y and fidelity, extraordinary accomplishment in the field of law enforcement in maintaining the security of the land, participation in relief and rehabilitation and for advancement of social-economic and political goals.

2) All members of the AFP for campaign against an enemy of the Philippines; or participation in unit massive operations within a definite period of time.

3) Units of friendly foreign nations for humanitarian service to the Filipino people.

4) U nits of friendly foreign nations for humanitarian service to the Filipino people.

b. Combat Commander's (Kagitingan) Badge - this is awarded by

the Commanding General, PA to PA officers and enlisted personnel who have commanded combat and combat support units for at least one cumulative year; all other PA military personnel who have rendered at least one cumulative year of combat duty regardless of their assignment, including those engaged in combat service support operations. Corresponding honorary badges may be awarded to all other personnel from the PAF, PN and PM who have been assigned to units engaged in combat, combat support and combat service support operations for at least one cumulative year, regardless of duty assignment or position.

c. Marksmanship Badge - this is awarded to officers, enlisted personnel, trainees and cadets of the AFP by the Commanders of Major Services, Unified Commands, AFPWSSUs, Division/Brigades and equivalent units in the PAF and in the PN. This award is given to the qualified personnel for his abili1y and proficiency in the handling of arms. Initially, the badge and the additional bar shall be awarded to military personnel who may acquire any qualification in the marksmanship training. And for each qualification, an additional bar shall be attached to the badge. The bar denotes the weapon and corresponding degree of qualification which may be a marksman, sharpshooter or an expert.

d. Adjutant General's Service Badge - this is awarded by The Adjutant General, AFP to all members of the AFP performing AGS functions. For officers to be qualified for the badge, they should have taken AGS training and performing AGS functions, or for those who have not taken the AGS training but performing AGS function for at least one yea.r. For enlisted personnel to be qualified, they should have taken administrative course, NCO Course and performing other activities related to administrative functions for

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at least tv.ro (2) years or those who have no formal training but performed AGS functions for at least two (2) years.

e. Tanglaw Badge - this is awarded to military and civilian personnel of the AFP by the Chief of Staff, AFP, Commanders of Major Services, Unified Commands, Divisions, AFPWSSUs, Separate Brigades and similar size units with TO rank of Brigadier General.

The personnel who fall under any of the following are eligible for

the badge:

a. Graduated from TANGLAW course conducted under the auspices and supervision of the CRS, AFP of not less than four (4) weeks in accordance with GHQ approved program of instructions (POI).

b. Graduated from TANG LAW course conducted by the Major

Service Schools and AFPHDTC of not less than four (4) weeks in accordance with GHQ approved program of instructions (POI)

c. Completed TANG-LAW Mini Course of Echo Seminar under the auspices and supervision of the CRS, AFP, Major Services and other AFPWSSUs and further actively participated in TANG LAW activities, projects for six (6) months.

d. Actively participated with competence in policy formulation, planning, direction, supervision and/or implementation of TANG LAW activities, projects and programs for at least one (1) year.

43. Letters and Plaques.

a. Letter of Commendation. It is a written expression of acknowledgment from a Commanding Officer or Head of Office given to military and civilian employee of the AFP for meritorious achievements, which do not meet the criteria for decorations.

b. Letter of Appreciation. It is a written expression of qualification

from a Commanding Officer or Head of Office given to military and civilian employee of the AFP to recognize acts or services which do not meet the criteria for decorations.

c. Major Service Commander’s Plaque. It is an award given by any Unit Commander to military or civilian employee in grateful acknowledgement of meritorious or outstanding accomplishment to the service command.

44. General. In accordance with Omnibus Rules Implementing Book V of EO Nr 292 Rule X s. 99, the following are awards for Civilian Employees:

a. Honor Awards. Honor awards shall consist of the following:

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1) Presidential or "Lingkod Bayan" awards is conferred on an individual for consistent dedicated performance exemplifying the best in any of the profession or occupation resulting in the successful implementation of an idea or performance which is of significant effect to the public or principally affects the national interest, security and patrimony.

2) Civil Service Commission or PAGASA Awards is

conferred on a group of individuals or team who has demonstrated outstanding teamwork and cooperation which resulted in the successful achievement of its goal and greatly improved facilitated the delivery or public service, effected economy in operation, improved working condition or otherwise benefited the government.

3) The Departmental Award or the "Kapwa" Award is given to an individual or group of individuals in recognition of contributions from an idea or performance resulting in direct benefits to a single department or agency in the government. Nominations for this category need not be submitted to the Civil Service Commission for screening and evaluation. The Department or Agency Suggestions and Incentive Awards Committee shall evaluate the nominations for this category and recommend to the head of the department or agency the most qualified awardees.

4) Outstanding Public Official/Employees Award or "Dangal ng Bayan" Award - it is granted to officials and employee in the government who have demonstrated exemplary service and conduct on the basis of their observance of the eight (8) norms of behavior as provided for under Republic Act No. 6713. Administration of this Award and the procedures of nomination shall be governed by Republic Act Nr. 6713 and its Implementing Rules.

b. The Incentive Award. The incentive awards shall consist of,

though not limited to the following:

1) Performance Incentive which shall be given to an employee who has obtained an outstanding or very satisfactory rating based on the Agency's Approved Performance Evaluation System for the last two successive evaluation periods which consist of step increments in accordance with the provisions of Joint CSC-DBM Circular No.1, s. 1990.

2) Length of Service Incentive which shall be given to an

employee who has rendered at least three years of continuous satisfactory service in a particular position and which shall consist of step increments in accordance with the provisions of Joint CSC-DBM Circular No.1, s. 1990.

3) Productivity Incentive that shall be given to an employee or group of employees who has exceeded their targets or has incurred incremental improvement over existing targets.

4) Most Courteous Employee Award which is given to an employee in accordance with tile criteria and standards established under

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CSC MC No. 15, s. 1990 which instituted the Courtesy Campaign Program in the Civil Service, known as the "Ang Magalang, Bow!"

5) Loyalty Award which shall be granted to an employee who has completed at least ten (10) years of continuous and satisfactory service in the government. This service award shall consist of cash bonus and a lapel emblem or loyalty pin differential as follows:

10 and 15 years -. bronze service pin 20 and 25 years - silver service pin 3 0, 35 and 40 - gold service pin

6) Retirement Award which shall be given to a retiree who

had rendered at least fifteen (15) years of satisfactory government service. This award shall be in the form of a plaque of appreciation, the design and citation of which shall be determined by the office concerned.

7) Year-end Benefits or Thirteenth Month BODUS Plus One

Thousand Cash Gift which shall be granted to officials and employees in the national and local governments, including state colleges and universities, and government-owned and controlled corporations in recognition of their dedication to government service and in keeping with the spirit of Christmas. The grant of these year-end benefits shall be governed by the Compensation Circular issued by the Department of Budget and Management in accordance with the provisions of Republic Act 6686.

8) Monetary Award which shall be granted to an employee's contribution in terms of suggestions or invention or performance of functions which results in monetary savings. When an employee's contribution can not be quantities in terms of monetary savings, or results in combined monetary savings and intangible benefits, the amount of cash award shall be determined in terms of a certain percentage of its estimated total value or benefit but not to exceed 20%.

9) Distinguished Honor Medal - this is awarded to an individual for outstanding contribution which has national significance in any of the following: demonstration of outstanding service, or contribution to the public administration in the form of exemplary achievement or through sustained interest and development; accomplishment of major operation or staff responsibilities which are clearly exceptional; and demonstration of outstanding courage and voluntary risk of life or honor under extremely adverse condition which result in direct benefit to the government or the protection of public interest.

10) Superior Honor Medal- this is awarded to an employee in recognition of significant contributions of unusual value not only to the agency but also to the public service in general. The criteria are any of the following: superior service leading to the achievement of agency program objectives;

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exceptional leadership in the fulfillment of agency program objectives; exemplary or courageous handling of an emergency situation; and superior creative service such as the development of a new and highly effective program which contributes to the agency's benefits or savings

11) Civilian Merit Medal - this is awarded to an employee in recognition of accomplishment worthy of commendation in the discharge of assigned tasks excelling normal position requirements or quality of their predominance; initiative in developing a new system or work methods; improvement of devices which results in substantial saving in manpower, material, cost and time; specific accomplishment for which an employee is responsible for the improvement in the agency operations or service, substantial savings in government funds and significant technical process; extraordinary devotion to duty under adverse conditions, and outstanding scientific, technical supervisory and executive ability.

45. Letters and Plaques.

a. Letter of Commendation - it is a written expression of acknowledgement of a Commanding Officer or Head of Office given to military and civilian personnel of the AFP for meritorious achievements, which do not meet the criteria for decorations.

b. Letter of Appreciation - it is a written expression of gratification

of a Commanding Officer or Head of Office given to military and civilian personnel of the AFP to recognize acts or services which do not meet the criteria for decorations.

1) Major Service Commander's Plaque - it is an award given

by any Unit Commander to military or civilian personnel or private persons, corporation or entity in grateful acknowledgement of meritorious or outstanding accomplishment to the service command.

2) Certificate of Honorable Service - this is awarded by The

Adjutant General, AFP and the Major Service Adjutant to all military and civilian personnel of the AFP who are honorably separated from the service, in recognition of their faithful and honorable service with the Armed Forces of the Philippines.

Section 3-15 Uniform 46. General. In accordance with Letter Directive dtd 21 Feb 1994. 47. AFP Technical Service Uniform (Refer to Annex I). 48. Dress Code Prescribed for all Nursing Service Civilian Personnel

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a. The office uniforms as prescribed hy the different government agencies/offices shall be the official attire of all government officials and employees that shall be worn in accordance with the assigned schedule.

b. On those days when the officials/ employees are exempted from

wearing the prescribe office uniform, they must be dressed appropriately; preferably business clothes. Party attires, picnic clothes, sandos or T-shirts without collars shall not be worn at work.

c. The following are prohibited/not allowed to be worn while at work:

1) Tight, fitting, seductive, micro mini, gauzy/transparent dresses by female employees

2) Walking shorts, pedal pushers, leggings, tights, jogging

and maong pants.

3) Costume jewelry, flashy bangles and similar accessories. Ostentatious display of expensive jewelry is strongly discouraged and prohibited except for special occasions and official celebrations.

4) Wearing of heavy or theatrical make up

5) Wearing of slippers, sandals, "bakya" in office premises, only appropriate footwear shall be allowed. For those assigned in all PA Nursing Services, the following are the prescribed uniforms:

(a) Female Nurses

(1) Whole Dress (For 7-3 Shift) Cloth - plain white, not too thin cloth man/ gabardine/cotton Collar - sports collar 2 3,4" wide Front - with three (3) pin tucks Sleeves - tailored 1 Y2" fold Belt - no buckle, 1 Y2" with two (2) plastic round white buttons Skirt - "A" line; length is 3" below the knee Pocket - slide

(2) Blouse and Pants for 3-11 & 11-7 Shift

(Annex B9) Cloth - Plain, white, not too thin, c1othman/ gabardine cotton single breasted with six (6) white medium round plastic buttons. Length of blouse shall not be less than 8" from the waistline Collar -- sports collar 2 3,4" wide Front - with three (3) pin tucks Sleeves - tailored 1 Y2 " fold

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Pocket - lower slide pockets 4 Y2 -5 Y2 " wide by 6" Pants -Cloth is plain white gabardine straight cut with waistband and with inside front pocket five (5) inches long diagonally set on both sides of the iliac region with a fly front opening secured by zipper and slide fastener :closure. Pants should be floor lengths bare footed

(3) Caps - white; style will follow that of the college/school where the civilian nurse graduated. Linen paper cap is not allowed

(4) Name Plate - indicate full name and

designation. Should be worn with uniform

(5) Jewelry - jewelries except gold/pearls stud 0.6 cm in diameter and wristwatch with second hand and wedding/ engagement/ college ring are not allowed.

(6) Stockings - plain white stockings

(7) Shoes - rubber sole; plain white; with or

without shoe lace

(b) Male Nurses

(1) Polo shirt Cloth - plain white, gabardine jc10thman or cotton Collar - sports collar Sleeves - short Pocket - patched pocket with flap cover

(2) Pants - white gabardine j c10thman cotton (3) Shoes - rubber sole, plain white. White

rubber shoes not allowed.

(c) Midwife Nursing Attendant

(1) Dress Cloth - plain white, not too thin cloth/gabardine cotton Cut - one whole dress "A" line Collar - sports collar 2 '12" wide Front - with three (3) pin tucks Sleeves - tailored 1 ~" fold

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Pocket - patch pocket Length - 3" below the knee;

(2) Name Plate - indicate full name and

designation

(3) Jewelry - jewelries except gold/pearls stud 0.6 cm in diameter and wristwatch with second hand and wedding/engagement/college ring arc not allowed.

(4) Shoes - rubber sole; plain white \with or

without shoe lace

(5) Stockings - shade of skin tone

(d) Male Institutional Worker

(1) Polo Shirt Color - plain light blue Cloth - gabardine/cotton Collar - V-neck shaped Sleeves - short Pocket - patched pocket

(2) Pants - denims

(3) Shoes - rubber shoes, any color

(e) Female Institutional Worker

(1) Uniform

Cut - one whole dress Color - plain light blue Cloth - gabardine/ cotton Collar - sports collar, 2 %" wide Front - with three (3) pin tucks Sleeves - tailored 1 7-2" fold Pocket - patched pocket Length _. 3 " below the knee

(2) Jewelry - jewelries except gold/pearls stud

0.6 in diameter and wristwatch with second hand and wedding/ engagement/ college ring are not allowed.

(3) Shoes - Rubber sole, plain white

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CHAPTER 4 OPERATIONS

Section 4-1 Nursing Service Administration and Management

1. General. To effectively manage the pillars of the Army Nursing Service, nurses as leaders or as subordinates must understand and apply the fundamental principles/functions of management. 2. Objectives of Nursing Service Management

a. To provide nursing care within the standards of safe nursing practice in the Phil Army Nursing Service.

b. To prepare nursing budget which will meet the requirements of

the Nursing Service in terms of personnel, supplies, equipment outlay and capital expenditures.

c. To maintain communication coordination and collaboration with other professional and support services.

d. To provide planned and continuous in-service programs for military and civilian employees assigned Nursing Service.

e. To promote research in nursing and to encourage participation in investigation of related disciplines.

3. Leadership - is the art of influencing the will of others in such a manner as to command their obedience, their confidence, their respect, their loyalty cooperation to create good discipline and healthy esprit-de-corps. The roles and responsibilities of today's leader are more complex than a century or even a decade ago. 4. Military Leader. An individual endowed with the basic concept of military leadership, being aware of his responsibilities, capabilities or his strong traits, guides himself by the principles of leadership. To accomplish this goal successfully, the leader must understand his men. He must also learn to recognize and evaluate the indicators of leadership proficiency, discipline, morale, and esprit de corps. Military laws and regulations enable the leader to compel outward obedience, respect" and cooperation, however, only personality can command the genuine confidence, respect and loyalty essential to successful leadership.

The true leader is one who by his qualities can create a worthy aspiration, and by precept 811d example can convert others to that aspiration, and lead them in an unselfish cause. The great military leader is the man who can inspire his men to do things they don't want to do and can make them

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enjoy doing them. The Nurse Corps officer endowed with the basic concept of military leadership as well as the pre requisites of leadership namely, physical proficiency, intelligence, and character. The first, physical proficiency is the resiliency which will enable the Nurse Corps leader to quickly recover under times of exceptional stress and immediately continue on with a new mission. The second, intelligence enables the leader to thoroughly understand from objective point of view and anticipate the problems which will be critical in the accomplishment of his mission. The third, character, will strongly determine the individuality of the leader; it will also be the basis of his attitude toward his responsibilities. Identified with character are such traits as loyalty, devotion to duty, and honor. Aside from the prerequisites mentioned a military leader must also possess the different traits of a good military nurse leader namely, knowledge, courage, initiative, decisiveness, tact, justice, dependability, bearing, endurance, enthusiasm, unselfishness, integrity, loyalty and judgment. The Nurse Corps officer as a leader must follow the Principles of Leadership enumerated:

a. Be technically and tactically proficient. b. Know yourself and seek improvement.

c. Know your men and look out for their welfare

d. Keep your men informed.

e. Set the example.

f. Ensure that the task is understood, supervised, and

accomplished.

g. Train your men as a team.

h. Make sound and timely decisions.

i. Develop a sense of responsibility among subordinates.

j. Employ your command in accordance with its capabilities. (11) Seek responsibility and take responsibility for your action.

In order to attain the ultimate objective of military leadership success in the mission, the leader must first develop in the individuals of his organization four (4) basic characteristics which will promote an efficient working team.

a. Proficiency. The measure of the individual and the unit's ability

to perform their job or mission. The technical, tactical, and physical ability to do a job well

b. Discipline. The prompt obedience to orders and in the absence

of orders, obedience to what the man believes the order would have been. Training is a part of the basis of discipline in which a military nurse must have

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an understanding of what is to be done and then be able to do it. Even more important to effecting discipline among subordinates may be the example that the military leader sets for his men.

c. Morale. The individual's state of mind how he feels about himself, his fellow workers and all other things that seem important to him.

d. Esprit de Corps. The opinion that the members of an organization have of themselves and their units. It is shown in loyalty and pride.

5. Excellent executive nursing leadership is vital to the survival of health care agencies in the current turbulent environment. Excellent nursing leadership attributes include administrative competence with adequate educational background, business skills and clinical expertise combined with the global understanding of leadership principles. As nursing leaders they emphasize nursing responsibility to influence the practice environment. They stress the importance of creating an environment in which the professional nurse can participate at both the Organizational and the professional level. The nurse executive whether as a military leader or as a nursing leader must perform all the tour (4) major management functions of planning, organizing, leading and controlling?

Section 4-2 Principles/Functions of Management

6. Planning. Entails forecasting or setting the broad outline of work to be done. It is formulating activities necessary to achieve the desired results in the Nursing Service. Planning is more crucial at the top management. The Army Chief Nurse plans for the broad organizational activities and are phrased in general terms. Strategic planning at the top level should be based on the mission, opportunities, threats, strengths and weaknesses of the organization. The Chief Nursing Service implements specific programs and projects. The Assistant Chief Nurse, Clinical Branch will follow up the implementation of programs/projects/ activities related to service, while the Assistant Chief Nurse, Admin Branch will follow-up programs/projects/ activities related to leadership and Assistant Chief Nurse Training and Education Branch will follow-up implementation of programs/projects/activities related to professional growth of military and civilian employees assigned Nursing Service. 7. Organizing - is the establishment of formal authority to meet the objectives of the organization. This entails the setting-up of Organizational structure, staffing and development of job description. Organizing is the process of grouping the necessary responsibilities and activities into workable limits, determining the line of authorities and communications and developing patterns of coordination. The Nursing Service constitutes the single largest group of hospital employees. It is the workforce of the hospital in supporting administrative policies, providing client care and promoting good public

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relations. There are title major concerns in organizing a Nursing Service, namely: organizational structure, staffing, and job descriptions. These are basically concerned with people and its quality, what they are supposed to do and how they are related to each other within the Nursing Service. At the middle management level, the supervisors formulate policies, rules and regulations, methods and procedures. At the lower or first management level, the head nurse/charge nurse schedules/ prepares/plans daily and weekly activities for the administration of client care for his ward.

a. Organizational structure - refers to the way a group is formed depicting its lines of authority, span of control, and channels of communication. The formal structure of an organization is the official arrangement of positions or working relationships that will coordinate efforts of workers of diverse interests and abilities. The philosophy and objectives of the Nursing Service and the goals of the hospitals are the bases for the formal organizational structure. This structure specifies how each position in the Nursing Service is related to each other and how the entire Nursing Service is related to other parts of the hospital,

b. Types of Formal Organizational /Lines of Communications:

1) Line - is the simplest and most direct type of organization where each position has general authority over lower positions in the hierarchy in the accomplishment of the main goals/objectives of the nursing service.

2) Functional - this type of organization permits a specialist

to aid line positions within a limited and clearly-defined scope of authority. It decreases the line manager's problem because it permits orders to flow directly to lower levels without going through the routine technical problems of line positions.

3) Staff-this is purely advisory and recommendatory to the line structure with no authority to put recommendations into action.

RELATIONSHIPS INDIVIDUAL 1. Line- those that exist between a supervisor; superior and subordinates immediately and directly responsible to him.

Chief Nursing Service to Supervisor; Supervisor to Head Nurse; Head nurse to Staff Nurse

2. Functional- those which arise to when duties are divided on a functional basis, i.e. when an individual exercise authority on one particular subject by special skill or knowledge.

Chief nursing Service with Admin Officer; Head nurse with the Clinical Instructor; Chief Nursing Service with the Ward Officers.

3. Staff- those which arise when an individual is acting as the representative of superior. This

Supervisor acting in behalf of the Chief Nursing Service when the Nursing Service is not around after

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individual is not vested with but is acting for and on behalf of the person on which authority lies. His function is one of transmission and interpretation couple with the duty of ascertaining that the orders given are carried out.

office hours. Staff Nurse acting on behalf of the Head nurse when the Head nurse is off duty.

c. Principles of Organization. Organization principles provide

simple groups of statements that provoke thinking among administrators.

1) Unity of Command - No member of the organization should report to more than one superior on any given function. This prevents conflict arising from orders from different people and simplifies superior-subordinate relationships.

2) Proper delegation of responsibility and authority. For work

to be accomplished, responsibility and authority should be delegated. Responsibility is work assigned to a position. Authority, on the other hand, gives the one delegated the right to command a subordinate who, in turn has an obligation to obey or perform the duties specified by his position.

3) Span of control - refers to the number of people one can directly supervise, assist, and teach to achieve the objectives of their own jobs. It ensures the appropriate number of persons needed to make the assignment manageable. (4) Departmentalization or similarity of assignments - Workers of similar activities is grouped together based on the likeness of personal qualifications or common purpose. This includes functions that require close coordination. Departmentalization specializes activities, simplifies the administrator's work and maintains control.

d. Organizational Charts. Organizational Charts are fundamental to

effective administration because they illustrate the lines of authority and responsibility, the major channels of formal communication, and the inter-departmental, as well as, the intra-departmental relationships. For the systematic and effective administration of the Nursing Service, the nursing department must be organized within the framework of the hospital's objectives and sound organizational principles. There are different types of organizational charts, namely:

1) Structural Chart - shows the various components of the

organization and outlines their basic interrelationships. 2) Functional Chart - reflects the functions and duties of the

components of the organization and indicates the interrelationships of these functions.

3) Position Chart - specifies the names, positions, and titles or ranks of the workers who are part of the organizational structure.

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e. Staffing. It is a process of determining and placing the right person to the right job. It is the process of determining and providing the acceptable number and mix of nursing givers to produce a desired level of care to meet the client's demand for care 24 hours divided into three (3) shifts. Staffing methods attempt to establish a set of patterns for distributing nurses to client areas based upon some predicted average workload conditions. There are several factors that affect staffing and other administrative requirements peculiar to the military service. Among them are:

1) Number of client 2) Acuity of illness

3) Characteristics of staff - what is the mixture of skill levels?

Are many on the staff young and experienced?

4) Domain and boundaries of Nursing Service- What services are the Nursing Service responsible for?

5) Latitude of flexibility - Is there flexibility for the delivery of care by different methods?

6) Turn-over of personnel

7) Group cohesiveness - How closely knit are the unit staff? (8) Resources available within the Nursing Service - Are these persons skilled in the staff development and in-service program?

8) Standards of care - Are the standards clearly spelled out and available to all staff?

9) Professional activity - How much active involvement is there with professional organization?

f. Client Classification - it is a means of clinically categorizing clients on the basis of certain needs that can be clinically observed by the nurse. It serves as a basis for staff planning. In most client classification systems clients are divided into four (4) categories on the basis of their dependency needs and the level of care givers required satisfying their needs. A four (4) category classification system consists of:

1) Level I - Self care/minimal care or nominal care category.

Under this category the client is capable of carrying out daily activities as long as the nurse provides the necessary materials and supplies. The client needs only 1.5 nursing care hours/day or nurse client ratio conversion of one (1) nurse is to five (5) clients.

2) Level II - Intermediate/moderate or partial care category.

Under this category the client can feed, bathe, toilet and dress him without help but requires some assistance from the nursing staff for special treatment

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or certain aspect of personal care. The client needs 3.0 nursing care hours/day or nurse client ratio conversion of one (1) nurse to three (3) clients. e.g partial care client might require assistance from the nursing staff to perform wound debridement or dressing, catheterization, or give intravenous fluid therapy, intramuscular or subcutaneous injection, etc.

3) Level III - Total care/intensive care category. Under this category the bed ridden client lacks the strength or mobility. Needs nursing assistance with all his daily activities, such as feeding, bathing dressing, moving, positioning, eliminating, comfort - seeking and injury avoidance. The client needs 4.5 nursing care hours/day or nurse client ratio conversion of one (1) nurse to two (2) clients. e.g. newborns are totally dependent on the mother or the nurse.

4) Level IV - Critical care/highly specialized care clients. An acute or critically-ill client who is in constant danger of death or serious injury would require critical care. The client needs 6.0 nursing care hours/day or nurse client ratio conversion of one (1) nurse to one (1) client.

The percentage of nursing hours to be given by professional nurses and by non professional nursing care giver depends on the client's condition and in the setting in which the care is being given.

For Level I clients, the ratio is fifty five percent (55%)

professional nurses to forty five percent (45%) non professional nursing care givers. For Level II clients the ratio is 60% to 40%; For Level III intensive care clients the ratio of 650/0 to 35% while Level IV clients needing highly trained nurses the proportion is 700/0 to 30%, or even 80% to 200/0.

Client’s Category Classification System LEVELS OF CARE Nursing Care Hours

Needed Per Patient per Day

Ratio of Professional to Non-professional

LEVEL I – Minimal Care 1.5 55:45% LEVEL II – Intermediate

Care 3.0 60:40%

LEVEL III – Intensive/ Total Care

4.5 65:35%

LEVEL IV – Highly Specialized/ Critical Care

6.0 70:30% or 80:20%

g. Scheduling. Providing client care every day around the clock

using nursing care givers who generally work five (5) days a week, one (1) shift per day for thirty (30) days. Scheduling or preparation of schedules for nursing care givers is usually done by the supervisors of each unit or floor for which they are responsible, if supervisors for each floor are available. In the PA Nursing Service for general and station hospitals, only one supervisor for each shift is on duty. In this set-up, head nurses should participate actively in

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the scheduling of nursing care givers. Since the head nurses are held accountable for workers expenditures over which they have control, they are therefore required to determine the stailing: needs for their individual units/wards. Therefore head nurses will prepare the staffing for their individual units/wards. In the preparation of monthly schedule by the head nurse. the head nurse should remember that the objectives of scheduling are to assign working days and days off to individual members of the nursing service so that adequate client care is ensured, while overstaffmg/understa.ffmg is avoided; that a desirable distribution of days off is achieved; that individual members of the nursing staff are treated fairly and lastly that the individuals know well in advanced what their schedules are.

h. PA Nursing Service has Formulated the Guidelines to be

Followed in Scheduling of Nursing Care Givers:

Consider that different levels of nursing care givers (registered nurses, registered midwives, nursing attendants) have different capabilities and that midwives and nursing attendants are legally allowed to perform only certain functions.

1) Nursing coverage must be provided 24 hours a day, 7

days a week. Nursing requirements are typically lower during the afternoon shift (3-11) and night shift (11-7) than during the day shift (7-3). Saturday and Sunday requirements tend to be twenty to thirty percent (20% to 30%) lower than week days requirements, due to lower client census.

2) Long stretches of consecutive working days usually

defined as more than five (5) days in a row are undesirable.

3) Schedules should represent a balance between the needs of the nursing care givers and the client (nursing care). When cont1icts arise, client care should have priority.

4) All military and civilian employees assigned Nursing Service should adhere to the established rotation policy. All requests and exceptions should be in writing and should specify the reason for the request.

5) Time schedules should be posted in advanced at least one (1) week before the change of schedules so that the nursing employees will be able to plan their personal lives.

6) Schedules should be established to provide correct numbers and mix of workers, allowing continuity, which is essential for quality care.

7) Schedules must conform to all labor laws as well as hospital and departmental policies.

8) Schedules must provide for rotation of shifts. The day shift (7-3) nursing staff must work on the afternoon shift (3-11) on the second

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month then on the night shift (11- 7) on the third month (if possible). Since no staffing scheduling method is perfect, there will always be problems; therefore staffing adjustments should always be considered when preparing the monthly schedules of the nursing care givers. Staffing adjustments should not be confused with regular scheduling. Staffing adjustments are concerned with undisputed conditions, the day to day variations in need or situations that result in over staffing or understaffing. Staffing adjustments are done each shift, with the assignment of the reliever nurses (if available) and / or the pulling of nurses from the units/wards where they were originally scheduled.

i. Determining the Number of Military and Civilian Employees

Assigned Nursing Service Needed. The number of nursing care givers to staff the various units/ departments should be sufficient to cover the service even when some of the workers are off-duty, absent or are on vacation/sick leave, or off on legal holidays.

The number of working hours and off-duties is largely dependent

on the Forty-Hour-Per-Week law (RA 5901). Relievers are needed because each Nursing Service care giver is entitled to fifteen (15) days vacation leave and fifteen (15) days sick leave, 2 off duties a week, and during holidays every year.

j. Distribution by Shifts. Studies have shown that more nursing

care is given during the day (7-3) and afternoon (3-11) shifts. The day shift requires the most number of nursing workers at forty-five percent (45%), the afternoon shift requires about thirty-seven percent P7%) and the night shift only about eighteen percent (18%).

k. Formula for Computing the Number of Staff Needed in the In-

Patient Areas of the Hospital. The Philippine Army Nursing Service has adopted the following computation prescribed in the Department of Health Nursing Service Administration Manual based on the Levels of Care:

1) Step 1. Categorize the number of clients multiply by the

percent of each level of care needed by hospital classification (whether minimal, intermediate, intensive or highly specialized.

Ex: 50 clients X .66 = 33 clients requiring minimal care or (66%) 50 clients X .24 = 12.0 clients requiring intermediate care or (24%) 50 clients X .06 = 3 clients requiring intensive care or (6%) 50 clients X .04 = 2 clients requiring highly specialized care or (4%)

2) Step 2. Find the total number of Nursing Care Hours

(NCH) needed by client per day at each categorized level.Number of clients at each level multiplies by the average nursing care hours needed per day.

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* Note: The NCH needed by the client per day at each level (Refer to Figure 4-1)

33 clients (Minimal) X 1.5 NCH = 49.5 NCH needed by 33 clients 12.0 clients (Intermediate) X 3 NCH = 36 NCH needed by 12 clients

3 clients (Intensive) X 4.5 NCH = 13.5 NCH needed by 3 clients

2 clients (highly specialized) X 6 NCH = 12 NCH needed by 2 clients

3-et the sum of the NCH in the various levels 49.5 + 36 + 13.5 + 12 = 111 ~CH needed by the 50 clients

3) Step 3. Find the total number of working hours needed by

these clients per year.

Total number of NCH needed per day x 365 days (total number of days in a year). 111 NCH X 365 days = 40,515 Total NCH needed by 50 clients per year

4) Step 4. Find the total number of working hours rendered

by each nursing care givers each year.

Hours on duty per day multiply by the actual working days per year. 365 days/year 104 off duties days/year (@ 2 off duties days week) 261 (working days/year) 8 hrs x 261 days = 2,088 working hours/year

5) Step 5. Find the total number of nursing workers needed.

Divide the total number of nursing care hours (NCH) needed by number of clients per year by the actual number of working hours rendered per year.

Total NCH needed by the 50 clients per year + actual number of working hours rendered per year. = 40,515 NCH + 1,848 hrs = 19.40 or 19 = 21.9 or 22 workers needed Find the relief. Multiply the number of nursing workers needed by .095 (Constant)

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23 nursing workers X .095 = 2.09 or 2 nursing Workers as relief

Add the number of relievers to the number of nursing workers needed.

2 workers as relief + 23 nursing workers needed workers needed 25 total nursing

6) Step 6. Categorize into professional and non

professional. Multiply the number of nursing workers according to the ratio of professional (60%) to nonprofessional personnel (40%). 25 nsg personnel x .60 = 15 prof (nurses) 25 nsg personnel x .40 = 10 non prof (nsg attendants)

7) Step 7. Categorize the professional nurses into NC

Officers and Civilian Nurses. Multiply the total number of nurses by the ratio of Nurse Corps Officers (60%) to civilian nurses (40%)

15 nurses x .60 = 9 Nurse Corps Officers 15 nurses x .40 = 6 Civilian Nurses

8) Step 8. Distribute by shifts. * See distribution by shift (sub

sec 4.14) 7 -3 = 15 prof x.45 = 6.75 or 7 nurses = 10 non prof x .45 = 4.5 or 4 nursing attendants 3-11 = 15 profx .37 = 5.5 or 5 nurses = 10 non prof x .37 = 3.7 or 4 nsg attendants 11-3 = 15 prof x .18 = 2.7 or 3 nurses = 10 non prof x .18 = 1.8 or 2 nsg attendants Total of 15 nurses and 10 nursing attendants

Based on bed capacity:

a) Step 1. Multiply the number of bed capacity by the

nursing care hours (NCH) needed per client per day.

Ex: 150 bed capacity x 1.5 NCH (Level I) = 225 NCH needed by 150 clients per day

b) Step 2. Find the total number of working hours

needed by 150 clients per year by multiplying the number of NCH by 365 days.

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225 NCH x 365 days/year = 82,125 NCH needed by the 150 clients per year.

c) Step 3. Find the total number of working hours

rendered by each nursing care giver each year by subtracting 149 days from 365 days.

365 days - 149 days = 216 Total Number of Working days/year.

To determine the number working hours per year multiply the total number of working days per year by 8 hours 216 working days x 8 hours = 1,728 number of working hours/year.

d) Step 4. Find the total number of Nursing Service Personnel needed to care for 150 clients. Divide the total number of NCH needed by the clients per year by the actual number of working hours rendered by the workers per year.

82,125 NCH 1,728 working hours

e) Step 5. Find the number of reliever needed. Multiply the number of Nursing Svc workers needed by .095 (constant).

= 47,5 or 47 workers needed

47 workers x .095 = 4.46 or 4 relievers needed

Add the number of relievers to the total number of Nursing Svc workers needed.

47 workers + 4 relievers = 51 Nursing Svc workers needed

f) Step 6. Categorize into professional and non-

professional. Multiply the total number of Nursing Svc workers according to the ratio of professional (60%) to non-professional (40%).

51 x .60 = 30.6 or 31 nurses 51 x .40 = 20.4 or 20 non-professionals

g) Step 7. Categorize into Nurse Corps Officers and

Civilian Nurses. Multiply the total number of nurses by the ratio of Nurse Corps Officers (60%) to civilian nurses (40%).

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31 x .60 = 18.6 or 19 Nurse Corps Officers 31 x .40 = 12.4 or 12 Civ Nurses

h) (8) Step 8. Section 4.7j)

Distribute by shifts (see distribution by shift (sub

7-3 = 31 prof x .45 = 13,95 or 14 nurses = 20 non prof x .45 = 9 nursing attendants 3-11 = 31 prof x ,37 = 11.47 or 11 nurses = 20 non prof x .37 = 7.4 or 7 nsg attendants

11-7 = 31 prof x .18 = 5.5 or 5 nurses = 20 non prof x .18 = 3.6 or 4 nursing attendants

Total of 31 nurses and 20 nursing attendants.

l. Modalities Used in the Assignment of Nurses in the Care of Clients.

1) Functional method - this method implements the

assigning of tasks to individual nursing service workers, such tasks are divided into sections or portions such as giving medications are assigned to nurses while giving bath, taking vital signs etc. are given to nursing attendants. This method is the most applicable when the nurses are limited in numbers. However, this method has some disadvantages - since the work is done piece by piece, the clients have to deal with so many nurses and therefore the clients find difficulty in relating to several nurses. Another disadvantage is that the nurses fail to identify the clients' needs.

2) Team Nursing Method - the head nurse or the

professional nurse acts as the leader of the group, she performs the highest degree of nursing care such as assessment, formulation of the nursing diagnosis, planning, directing nursing care and evaluating the nursing care outcomes. The head nurse presides over a daily care planning conference, wherein all the members are required to attend. During this conference all the members of the team are encouraged to discuss the case and suggest measures that 'will improve the care of the client. Each member is assigned a particular task to perform. The focus of this method is on the client, the nursing care givers and the work.

3) Primary Nursing Method - involves accountability for a small number of clients from admission to discharge. It allows a one to one nurse client relationship. Primary nursing utilizes the nursing process. The nurse is accountable to the client twenty four (24) hours. The nursing care plan (NCP) is reviewed and evaluated through the daily care planning

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conference. The nurse is able to identify the client's needs and therefore the nurse can deliver better quality nursing care. Under this modality, care is focused on the client. How-ever, the disadvantage of this type of nursing modality is its higher cost because more nurses are needed.

4) Case Management - it is a clinical system for the strategic

management of cause and quality outcomes. It provides clients and their families with a collaborative plan based on standards of care yet, individualized by groups of clinicians who have expertise in their case types.

m. Job Description. A statement setting forth the duties and

Responsibilities of a specific job and the characteristics of the individual needed to perform the job successfully. Job descriptions have become increasingly important as a management tool - a tool that management needs to make certain that responsibilities are wisely delegated, work efficiently distributed, talents fully used and morale maintained. 8. Leading. Refers to the manner of delegating assignments, orders, and instructions to the military and civilian employees assigned Nursing Service such that the latter is made aware of the work expected of him. The nursing service both military and civilian employees should be properly guided so they can contribute effectively and efficiently to the attainment of the nursing service goals.

a. Communication. Is the string that binds an organization by

ensuring a common understanding? Communication of the different groups in the organizational structure is usually tri-dimensional because it portrays three dimensions of vision. Down wards communication means flow comes from higher to lower authority. On the nursing service, the Chief Nursing Service communicates with all the Assistant Chief Nurses (Clinical, Admin, Education & Training and Research) and supervisors. In their absence, the person next in rank takes their places. Written communications from the Chief Nursing Service to the nursing care givers are usually concerned with general nursing service policies, directives, and activities. These are coursed across the line through the Assistant Chief Nurses down to the supervisors and head nurses for interpretation, when needed.

Upward communication is a flow of information. It is a communication circuit wherein the message of the sender is taken by the receiver. The receiver responds back to the sender.

When a supervisor receives a communication from the Chief Nursing Service, supervisor also gives back written reports of information within his area as to how this communication was acted upon. The supervisor's close association with his subordinates gives him the opportunity to communicate back botl1 in action and/or verbally, the impressions, interpretations, conclusions of the nursing care giver about the communication or any difficulty they may have encountered in the implementation of the communication.

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1) Horizontal communication is the type of communication

used during conferences or discussions between the different members of the health team. It is the exchange of ideas, information and feelings and such exchange usually take place during rounds and conferences. Nursing care giver should take advantage of this kind of communication, as it maximizes the interchange of ideas for better understanding. This type of communication also includes the discussion of the total care of clients. In the Nursing Service, communications/instructions are carried out through oral and written reports following standard lines of communication.

(a) Oral communication - is the most effectual' means of informing the Nursing Service care givers of the plans, developments, changes and problems within the hospital and of the Nursing Service.

1) Client contact -- nursing care givers who are

in regular and frequent contact with the clients can explain to the clients through verbal communication all the policies, regulations, hospital services as well as the nursing care plan for the clients.

2) Individual/ group conferences - plans,

problem, and activities of the Nursing Service are better explained and discussed during these conferences.

(b) Written Communication - serves as a reference for

Nursing Service care givers to get instructions or guidance. It also serves as a record of standards of practice. Written communications in the Nursing Service usually are in the forms of:

1) Policies - are written guides or basic rules

that govern actions of nursing workers.

2) Memoranda or memos - are written notes or information exchanges between the Nursing Service staff and its workers. i.e. Chief Nursing Service sends a memo to the supervisors to inform all nursing care givers of the weekly activities.

3) Directives - are administrative orders which

give instructions to all military and civilian employees assigned Nursing Service and initiate actions for them to be followed on certain situations, i.e. Chief Nursing Service sends out a directive concerning standards of care.

4) Manual of Operations - are written

procedures and techniques of the Nursing Service wards which are kept on me for ready reference, i.e. Nursing Procedure Manuals which are kept in the Nurse's Station for ready reference.

5) Records and Reports - accounts or

information on facts/events in written forms as an anecdotal or spot report.

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b. Coordinating. The Nursing Service serves to unite the hospital's various functions ""ith other departments and other community agencies through proper coordination. Coordination helps the Nursing Service achieves its mission and objectives when each workers complements the work of the other.

9. Controlling. Is the use of formal authority to assure the attainment of the Objectives of the action to the maximum? Through controlling the Chief Nursing Service views the rendering of quality nursing care as the institutional control of process that brings sick clients back to good health. Controlling also paves the way for the Chief, Nursing Service to examine carefully the devices used to control their service. The following are the control measures used by the Nursing Service:

a. Total Quality Management b. Staff Visit

c. Performance Appraisal d. Records and Reports

d. Quality Circles

e. Nursing Rounds

f. Bedside Clinic

g. Risk Management

Section 4-3 Total Quality Management

10. Definition. Total quality management is a philosophy in maintaining and improving quality through a well functioning system that provides quality while keeping costs to a minimum. 11. Activities of total Quality Management. To assure the provision of quality care, the Total Quality Management consists of the following:

a. Developing the vision and values of the organization b. Leadership development

c. Standard Development - based on professional practice and

provides content for criteria development.

1) Develop written standards 2) Conduct chart reviews to validate documentation on

implemented standards

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d. Continuing Education

1) Maintain ongoing CE events list 2) Use mandatory CE events list

3) Create individual CE attendance records

e. Credentialing

1) Conduct annual licensure validation 2) Maintain certification list

3) Develop special procedure approval

f. Performance Appraisal. Track staff performance basis and

incorporate QA findings.

g. Audit

1) Conduct six (6) compliance reviews per year: structure, process, outcome

2) Conduct non-compliance reviews as needed

3) Review unit documentation twice per year

4) Perform one (1) annual staff survey for satisfaction/

dissatisfaction

5) Perform one (1) annual client survey for client satisfaction

6) Conduct one (1) annual generic nursing review

h. Concurrent Monitoring. Plan & conduct mini-reviews on current topics

i. Risk Management

1) Conduct one (1) environ safety review per quarter, Alternate with infection control review

2) Perform regular checks on equipment and drugs (3)

Record preventive maintenance

3) Track incident occurrence and records trends

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j. Continuous Quality Improvement (CQI) A management style. That supports and enhances the efforts of quality assurance. The focus is on improving care and service. CQI requires examination of the Processes of care and service in order to improve outcomes. Quality assurance and CQI are complementary. Quality assurance activities enable identification and resolution of problems. CQI goes beyond the problem-oriented approach; the data derived from monitoring is used to continuously improve - even in the absence of problems. For the CQI concept to succeed quality must be a priority at all levels within the organization. Staff must be encouraged to improve care. There must be multi disciplinary and interdisciplinary review of systems and service with efforts focused on improvement of processes and systems.

k. Utilization review.

1) Maintain unit log for tracking 2) Create utilization records for productivity and utilization

(3) Maintain budgetary records

l. Active Problem Identification! Ongoing Monitors and Problem Solving.

1) Create problem ill report sheets 2) Track trend problems with written log

3) Problem solving and implementation

4) Conduct area conferences and track results

5) Conduct supervisory rounds weekly and complete report

sheet

6) Delegate monitoring and follow-up QA actions 12. Framework for Evaluation. The evaluation of quality nursing care is determined by the appropriate combination and interaction of structure and process. The basic assumption is that an adequately supported structure and process ensure the attainment of desired outcomes. Evaluation standard is set within these three (3) areas: structure, process and outcome.

a. Structure - refers to the conditions and mechanisms that support or facilitate the delivery of nursing care which include among others, physical facilities number and quality of workers, its qualifications, functions, organization and administration of the Nursing Service, communication system and staff development.

b. Process - Process Standards are used to describe the activities

of the nurse necessary to provide care. This is the nursing process; it

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identifies what constitutes and monitors actual performance of the care giver and focusing primarily on behavior directly related to clients.

1) Job description 2) Performance appraisal

3) Standards of Performance

4) Procedures

5) Protocols

6) Guidelines

c. Outcome - Outcome Standards are goal statements which may

be written as client or nursing goals with the purpose of specifying end results to be achieved by the client as a result of nursing care given, assessing client status, physical and otherwise, particularly in relation to the problems that caused hospitalization or breakdown in health. Outcomes are the results of care to those served and the ultimate validators of care.

13. Steps in Developing a Quality Assurance Program

a. Formulation or review of the Nursing Service philosophy and objectives. The basic assumption is that the Nursing Service's philosophy and objectives are congruent with those of the health care facilities and the Department of National Defense and Department of Health.

b. Formulation or review of standards. The nursing administration

should lead in the formulation, review, or revision of nursing standards is it in the area of clinical practice and/ or service administration.

c. Formulation of evaluation tools. The evaluation instruments are formulated to determine the attainability of the standards set. These may be in the form of questionnaires, interview schedules, or observation checklists.

d. Data collection. Prior to actual collection, a good sample should be established randomly. Data gatherers should also be trained particularly on the mechanisms of random sampling, interviewing, administering questionnaires and observation.

e. Data analysis. Results of the evaluation are statistically presented and summarized in the form of measures of central tendency mean, median and mode. Prior to data analysis, the Quality Assurance Program Committee must first determine the expected performance level and which corrective actions are taken. What is the "acceptable" or "safe" nursing care? The definitions will definitely reflect the standards set by the institution and identify possible corrective actions.

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f. Taking action/Implementation. Based on the analysis of findings,

corrective actions should be recommended to the Chief Nursing Service. In cases where identified deficiencies require a higher level of intervention, recommendations are submitted by the Chief Nursing Service to the Commanding Officer. Resolution of the problems necessitates the administration's commitment and the agency's available resources. 14. Quality Circle. A group of people (usually 4 to 15) who work in the same or similar area who voluntarily meet on a regular basis to identify assess and solve problems in their area of work. 15. Monitoring and Evaluation Process. There are ten steps that are necessary for effective monitoring and evaluation in the Nursing Service.

a. Assign responsibility b. Delineate scope of care

c. Identify important aspects of care

d. Identify indicators related to these aspects of care

e. Establish thresholds for evaluation related to the indicators

f. Collect and organize data

g. Evaluate care when thresholds are reached

h. Take action to improve care

i. Assess the effectiveness of the action and document

improvement

j. Communicate relevant information to the organization wide QA program

16. The Nursing Service Audit. The Nursing Service Audit is an official examination of nursing records, physical facilities and employees involved in client care for the purposes of evaluation, verification and improvement. It is a tool in analyzing and evaluating nurses' bedside records and physical facilities. It serves as a means of improving nursing care by revealing existing deficiencies. 17. Nursing Service Audit Committee. The Nursing Audit Committee should consist of a chainman, a co-chairman, a qualified secretary, and a Number of selected members. The committee may be composed of the following: the Assistant Chief Nurse Clinical Branch (as the chairman), staff from the Nursing Education, Clinical Supervisor, staff from the Nursing Admin Branch and a general duty nurse/staff nurse. The Chief Nursing Service on

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the other hand, is an ex-officio member. Selection of the committee members is done on a rotation basis with overlapping tenure of service. The Chairman of the Audit Committee and the Chief Nursing Service should be appointed to fill vacancies that may occur. Regular audit committee meeting should be held at least once a month. However, special meetings may be called as the need arises. Minutes of the meetings should always be kept on meso 18. Functions of the Nursing Service Audit Committee.

a. Phase One which include:

1) Specifying purpose and objectives 2) Establishing criteria and standards

3) Establishing the guidelines for conducting audits

4) Deciding upon necessary forms (adapting forms to

needs)

5) Practice auditing to become proficient

6) Keeping brief pertinent minutes of all meetings including date, place, time, members and guests present, topics discussed, actions agreed upon, recommendations and progress on previous recommendations.

b. Phase Two which include:

1) Establishing new criteria and standards 2) Measuring actual practice against criteria

3) Evaluation of results

4) Action taken to correct deficiencies

5) Prepare and distribute summary reports

19. Committee Activities. The Nursing Service Audit Committee should meet to review the records of discharged clients. The audit may be conducted on a segregated service. The records of all clients discharged from one unit may be audited in one meeting. The time and period of the audit may vary depending on the size of the institution. However, all succeeding audits should be conducted on the same period to make comparison of the various reports possible. Equipment and supplies as well as the nurses' clinical records must be appraised. The appraisal would determine their quantitative values and to make provisions for all the needs involved in quality client care. 20. Responsibilities of the Committee. All members of the Audit Committee must have free access to the evaluated record forms. The

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Chairman of the Audit Committee should inform each individual concerned regarding the latter's deficiencies and suggest ways or means by which these deficiencies may be improved. The deficiencies of the individual nurses should be recorded on individual file cards. A regular system of follow-up on the concerned nursing care giver's performance should be established. 21. Some Guidelines in Implementation of Nursing Audit

a. Qualifications of Nursing Audit Committee Members:

1) Demonstrated skills in applying the nursing process, communications and in relating to others.

2) Interest and willingness to work for quality client care

3) High level of integrity and respected by the staff.

b. Criteria of Clients Qualifying for Audit.

1) Clients considered SIL and have been in the hospital for

at least 2-3 days. 2) Intermediate care clients who have stayed in the hospital

for at least a week.

3) Those that have undergone medical or surgical procedures.

c. Method of Selecting Clients for Audit- Random. d. Frequency of Audit and Time of Audit - Once a month or

quarterly, but the actual date should not be known to the staff.

e. Reporting. The Nursing Audit Results should be submitted to the Chief Nursing Service of the general/ station hospital for appropriate action. The Office of the Army Chief Nurse should also be furnished with a copy of said result together with action taken for monitoring and for further actions if necessary.

22. Organizing for Nursing Service: Audit. It is the responsibility of the Chief Nursing Service to:

a. Initiate and maintain a Nursing Audit Program

b. Organize for audit using a method decided upon within the scope of nursing practice

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c. Utilize the basic steps in the audit procedure.

d. Evaluate the kind of service being given within the direction of the Nursing Service.

23. Performance Appraisal. Performance appraisal is done to help an employee improve his work methods to ensure the achievement of organizational goals. Each employee should be evaluated by the line supervisor. Thus, the Assistant Chief Nurses are evaluated by the Chief Nursing Service. The supervisors will be evaluated by the Asst Chief Nurse for Clinical Branch, the head nurses by the supervisors, the staff nurses and the nursing attendants by the head nurses. 24. Evaluation Principles

a. For a worker's performance evaluation to be valid, it must be based on his job description and performance standards.

b. An adequate and representative sampling of the nursing care

giver's behavior should be observed in the process of evaluating performance. Care must be taken to evaluate his usual or consistent behavior. Focusing on, or magnifying an isolated instance of either extremely capable or extremely inept behavior on the part of the nurse should be avoided.

c. The nursing care givers should be provided with a copy of his job description, performance standards and evaluation form to review prior to the scheduled evaluation conference so that nursing care giver and his supervisor can discuss the evaluation from the same frame of reference.

d. In documenting the employee's performance appraisal, the superior should indicate clearly those areas wherein the care giver's performance is satisfactory and those which need improvement. The superior should refer to specific instances of the care giver's satisfactory and unsatisfactory behavior in order to clarify exactly what types of changes are required in his performance.

e. If there is a need to improve the care giver's performance in several areas, the superior should indicate which area(s} should be given priority by the care giver.

f. The evaluation interview should be scheduled at a time convenient for both the care giver and the supervisor. It should be held in a pleasant surrounding and should allow time for both parties to ask questions and discuss the evaluation at length.

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Section 4-4 Nursing Process 25. General. Republic Act Nr 7164 Article V Sec 27 states that the scope of nursing practice includes the utilization of the Nursing Process. Nursing Process is a problem solving framework for planning and delivering nursing care to clients and their families. It is a way of thinking as a nurse. It is a framework of interrelated activities resulting in competent nursing

Chief Nursing Service

Asst Chief Nurse Clinical Branch

Nursing Supervisor

Head Nurse

Staff Nurse

Wardman/midwife/ nursing Attendant/ utility worker

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care. It is dynamic and cyclical in nature, requiring repeated review. It is a scientific, problem-Oriented approach to client. 26. Steps in Nursing Process. The nursing process is divided into five (5) steps

a. Assessment. Let me have a look at that. Tell me about it

Assessment is the first step in nursing process and the one step which is a part of every step in the nursing process. The nursing assessment which the nurse completes upon the client's admission to the hospital is focused on the client's response to actual or potential health problems. During the assessment the nurse collects data by interview, observation, and examination. The nurse does not make judgments or conclusions at this time but focuses on establishing a comprehensive data base which reflects the health status of the client. The nurse seeks to gather only data, not judgments and conclusions, from the client.

b. Diagnosis. What is the problem? What is the cause? How do I

know it?

The process of making a nursing diagnosis consists of three (3) activities namely: data analysis, problem identification, and formulation of nursing diagnosis. During data analysis the nurse makes decisions based on the data regarding the health status of the client. Next, the nurse identifies problem focus areas and finally states a nursing diagnosis. The nursing diagnosis includes the client problem and cause or etiology if known. The statement may also include signs and symptoms if the nurse is using the PES format. If it is a potential nursing diagnosis, the nurse includes the identification of risk factors which determine the diagnosis.

c. Planning. What are we going to do about it? What is the best

strategy? What do we want to happen?

During the planning phase of the nursing process, the nurse and the client set priorities among the identified problems; establish goals showing reduction, prevention; or elimination of the problem; and plan interventions to achieve the goals. A goal is the desired outcome of nursing care in the form of changed client behavior. For actual nursing diagnosis, the goals identify client behavioral outcomes demonstrating a lessening or elimination of the problem. For potential nursing diagnosis, the goals demonstrate the client maintaining the current level of functioning or prevention of the problem. Goals give direction to nursing actions as do the nursing diagnosis. Long term goals often demonstrate the maximum level of functioning for the client or restoration of normal functioning and may take days to months to achieve. Short term goals describe client outcome behavior in smaller steps. They might be more appropriate in a critical care setting or when the client is unstable and the problem must be reduced or eliminated rapidly. Short term goals may be set

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in a time frame from hours to days. Progressive short term goals can be used to show continued progress, in terms of improved level of client functioning in the direction of long-term goal achievement. A goal statement contains the client's behavior, the criteria of acceptable performance of that behavior, the time frame in which the goal should be achieved, and the conditions, if any, under which the behavior will be demonstrated. Goals are realistic, observable, congruent with other health professional's plan of care, and directly related to the nursing diagnosis.

Nursing interventions are those specific activities the nurse plans and implements to help the client achieve a goal. There are four (4) broad categories of nursing interventions, and the plan of care often incorporates actions from several of these groups: environmental management, physician initiated and ordered interventions, and nurse initiated/nurse ordered interventions. The last group of interventions is solely within the realm of nursing practice and includes health teaching, counseling, and referral; specific nursing treatments; assisting with ADLs; assessment of client status, progress, and response, assistance with problem solving and providing encouragement and support. Nursing interventions deal with the etiology or risk factor of the problem Identified in the nursing diagnosis and try to reduce or eliminate them. If that is not possible, interventions are aimed at lessening the problematic signs and symptoms to assist the client cope with the problem.

Nursing interventions are safe for the client, specific congruent with plans of other health professionals and realistic for the client, the nurse, and the health care setting.

d. Implementation. Move into action. Carry out the plan Do it!

It is the fourth step in the nursing process and the focus is on

the nurse working with the client to carry- out the plan of care. Implementation consists of validating the care plan (is it safe, reasonable plan indicating quality nursing care?), documenting and communicating it, but the primary component is actually giving care to the client. The nurse documents this care and the client)s response to it in the chart. As the nurse gives care, assessment of the client continues. Documentation is done in order to see the client's response to the interventions and to provide information for revising the plan of care as client status changes. The client is an active participant in care working out with the nurse to adapt interventions as they are given and having the right to refuse or request interventions. The nurse is flexible, open to suggestions and changing client priorities but committed to helping the client understand and accept nursing care to promote health and reduce, eliminate, or prevent problems.

e. Evaluation.

Did it work? Why didn't it work? Did we end up where we wanted to? Are we done or is there more? What is the problem?

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It is the [mal step in the nursing process. The first part of

evaluation involves evaluation of goal achievement. This goal evaluation is documented in the chart "with a description of the client's outcome behavior as evidence of the degree of goal achievement.

The second part of evaluation is to review the plan of care. This

involves updating the data base, deciding if original diagnosis are still accurate, adding new diagnosis or identifying original ones as resolved, revising the goals and interventions based on more complete information on the client and the effectiveness of the original plan, and finally implementing the updated plan. This is again followed by goal evaluation and care plan review to reflect the dynamic state of the client.

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CHAPTER 5 MANAGEMENT OF CLIEN'T CARE

Section 5-1 Extended Functions of Nurse Corps Officers

1. General. The AFP cognizant of the complications that arise in emergency and mass casualty situations particularly in the absence of a medical officer has defamed additional specific duties and responsibilities of Nurse Corps officers as indicated in the AFP Policy on the Extended Functions of Military Nurses. This means more trainings, assignments, and utilization of Nurse Corps officers on the performance of functions normally performed by medical officers. These are the extended functions of Nurse Corps officers in accordance with AFP Directive on Extended Functions of Military Nurses dtd 17 April 1975.

a. Administration of anesthesia in normal elective surgery and emergency cases of military personnel, their dependents and authorized civilians confined in military hospital units, installations and in other instances with military missions in the absence of a Medical Officer.

b. Maintenance of patent airways, suction, intubations, artificial

respiration and tracheotomy, if trained to perform such procedures in extreme emergencies in the absence of a medical officer;

c. Institution of life saving measures such as oxygen inhalation, administration of stimulants and external cardiac massage in extreme emergencies pending arrival of a medical officer;

d. Management of normal deliveries;

e. Catheterization of both male and female patients;

f. Administration of immunizing agents under the supervision of a medical officer; and

g. Sorting of patients in mass casualty situations.

Section 5-2 Emergency and Disaster Nursing Management

2. General. The need for professional nurses to be prepared in emergency and disaster nursing becomes more evident as the complexity of our lives increases owing to the discovery of new scientific knowledge and the needs of the populace. Professional nurses need to be prepared to meet everyday emergencies in terms of first aid and lifesaving measures. Nurses' functions are expanded further on .the case of mass disasters, either resulting

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from natural or man-made phenomena, including enemy attack. This section deals with disaster planning, organization and management of mass casualty situations in armed con11icts and disasters. 3. Planning Considerations for Disaster Nursing. There are three fundamental preparations needed to cope with disasters regardless of type or magnitude.

a. The adaptations of all skills to any emergency situations. b. The ability to resettle resouvcefu1ness with both supplies and

equipment a realistic approach to the selection of the essential nursing procedures and the courage to eliminate the non-essentials.

c. The ability to utilize and teach auxiliary nursing personnel 4. Management of Mass Casualties

a. Sorting - The care of mass casualties is based on the greatest good for the greatest number at the right time and place. The key to management of disasters is triage or sorting of casualties according to an understood plan.

1) In general situations, the serious/critical clients on a given

unit will be cared for first, with semi-ambulant client’s next and ambulatory patients or those requiring the least care, last;

2) In emergency or disaster situations, the principle of first

caring for those requiring lifesaving measures, then for those who are seriously injured, leaving minor injuries last, shall be practiced;

3) In the case of thermonuclear situations, triage assumes a different function based on the principle of providing the simplest measures that will save the greatest number of lives. Instead of concentration on the most critical casualties, available manpower and supplies should be used for the maximum number of people who can be saved. While the hopelessly injured should not be abandoned but made as comfortable as possible, efforts must be directed toward treating the thousands who may respond quickly to lifesaving treatment; and

4) Combat Situation. The wounded are sorted at the first level health care facilities, the battalion aid station. Here, the casualties from the front lines receive first treatment and are assembled for collection. From this area, they are collected by elements of the evacuation section, and evacuated by land, air or water to the clearing stations which could either be a fixed or a mobile medical infirmary, a station hospital, or in the absence of both, could be a public or private clinic or regional hospital, whichever is available in the locality. These health care facilities serve as holding units where casualties are treated and accumulated in preparation for evacuation to

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the final or ultimate health care facilities in the chain of evacuation, the general hospital and/ or AFP Medical Center. 5. Treatment of Mass Casualties

a. First aid and rescue; b. Emergency medical treatment - the prime objective is to

preserve life and limb and to prevent or arrest physical deterioration until more definitive treatment can be given; and

c. Definitive medical/ surgical care. 6. Principles in the Care of Mass Casualties

a. All medical management must be directed toward the good of serving the greatest number with resources.

b. No casualty is to be considered abandoned, but concentration of

medical effort in the few, denies appropriate care to the many.

c. Time is an important factor. The longer the delay of medical cares for a seriously injured casualty, the less is his chance for recovery. The system should be organized so that immediate first aid can be provided, through self help, neighbor help, and teams from first aid stations.

d. Casualties must be transported carefully and quickly to the nearest health care facility for further management by skilled personnel.

e. Skilled medical personnel with essential diagnostic and therapeutic equipment should be brought as close to areas having casualties as circumstances will permit.

f. Initial medical and surgical supplies and equipment must be available immediately and large reserve stocks are made ready for movement to affected areas

g. The magnitude of the supply needs, demands uniformity in the management of specific types of injuries.

h. Adequate transportation will be required to move casualties from disaster areas to first aid or clearing stations, and then to local and distant hospitals.

i. Communication between casualty service units is a prerequisite to an orderly movement of casualties and supplies between facilities.

j. Skilled medical personnel should not be used for first aid and rescue operations.

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k. The use of narcotics should be held to the minimum. Nothing should be done to a casualty that will decrease his capacity to care for himself.

l. Triage or sorting is the key to the successful management of mass casualties.

Section 5-3 Health Service Support

The objective of the Health Service Support (HSS) System is to

conserve trained manpower through the prevention of adverse effects produced on combat efficiency by unevaluated clients. Accomplishment of this objective involves the careful evaluation (sorting) of the wounded in relation to the capabilities of the medical echelon involved and the treatment of such wounded on their evacuation to the rear. The health service support system provides a continuum of care which starts at the point or area of injury or wounding and continues through the area of operations to the hospitals for treatment or to other installations for disposition. The general plan of evacuation and hospitalization within the area of operation is the responsibility of the surgeon in accordance with the evacuation and hospitalization policies. These policies will determine which clients will be evacuated and will designate a maximum number of days for allowable period of hospitalization within the area of operations. The time set may vary from 30 to 120 days an increment of 30 days. This does not mean that the client is held at each level of medical treatment for the limit of the time set, but that his total fixed hospitalization time in the theater does not exceed the number of days specified. In conformity with the theater evacuation policy, subordinate commanders establish evacuation policies subject to the approval of the theater commander, indicating the maximum period that clients may be held in their particular areas or installations. For example, a shorter evacuation policy may be established for striation hospitals than for general hospitals. In the area of operations, the policy may vary from hour to hour and day to day. If a client is admitted to a station hospital but whose recovery is likely to require more than the number of days of policy would be evacuated to a general hospital. Wounded soldiers must not be permitted to go farther to the rear than his physical condition requires. Soldiers with minor wounds and minor illnesses are returned to duty as soon as possible from as far forward as possible in the evacuation system. Generally the evacuation flow begins at the unit level from the moment clients receive aid from the company aid man and walk back or are carried to a collecting point or aid post. These clients follow the primary line of evacuation to a point as far rearward as is consistent with their injuries and the tactical situation. From the company collecting point or aid post clients are taken (usually by ambulance) to the battle group aid station, the first medical station in the evacuation system. Transportable clients via ambulances proceed to the division clearing station and later to an evacuation hospital. Non transportable patients and those who must have immediate surgery are moved or evacuated via Phil Air Force aircraft, to a Mobile Army Surgical Hospital (MASH) located in the division or they may be

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evacuated directly to a station hospital via Phil Air Force aircraft where they will rejoin the primary flow of evacuation. From there, they may be further evacuated to an army general hospital. If further evacuation is needed they are brought to the AFP Medical Center. From the MASH, clients may be directly evacuated to AFP Medical Center. It must be remembered that at any point in the evacuation system, the soldier will be returned to duty if it is possible.

The availability of sufficient transportation (ship, plane, helicopter, or motor vehicle/ ambulance) determines the degree to which evacuation can be accomplished. For the health service support system to achieve the systematic and prompt evacuation of the sick and wounded soldiers. Health Service Support System is tailored into echelons or levels of care of the medical evacuation. The echelons of medical evacuation are as follow; (Annex E)

a. Echelon 1, unit level, HSS system is provided by designated

elements or individuals organic to the unit. These individuals are found in the combat, combat support and combat service support units. Major emphasis at this level of support is to stabilize and evacuate the casualty. Necessary measures are taken to treat and medically stabilize the casualty for evacuation to the next level of care. The combat medic or medical aid man is the first individual in the HSS system who makes medically substantial decisions based on his special training as a medical specialist.

b. Echelon II, division level, HSS is usually conducted at the

clearing station. The clearing station initially examines the casualty. The wounds and the general status of the casualty are evaluated. This evaluation determines priority for treatment or evacuation. Emergency care including initial resuscitation continues. If necessary, additional emergency measures are instituted.

c. Echelon III, a medical treatment facility (MTF) provides Echelon III HSS. Tills facility is staffed and equipped to provide resuscitation, initial wound surgery and post operative treatment. Clients whose wounds/injuries are life threatening may receive surgical care in a mobile army surgical hospital (MASH) in the division rear area.

d. Echelon IV. A medical treatment facility also provides Echelon IV HSS. This facility is staffed and equipped for general and specialized medical and surgical care and reconditioning rehabilitation for return to duty.

7. Utilization of Nurse Corps Officer in Echelons of Medical Evacuation. The Army Nurse Corps officer may be assigned in medical infirmaries which is located in Echelon II. The number of Army Nurse Corps officer assigned in medical infirmaries varies depending on the number of troops to be catered by the medical infirmary. As the level of echelon goes higher, the number of Nurse Corps officers assigned as well as their level of knowledge and skill also go up.

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CHAPTER 6 HUMAN RESOURCE DEVELOPMENT PROGRAM

Section 6-1 Military Training and Education

1. General. The Army Nurse Corps officer being a military officer undergoes military training to provide the appropriate knowledge, high level of skills, discipline, motivation- required of the expanded role of the military today. These are the following courses given to Army Nurse Corps Officers in the active service. 2. Lower Level Courses

a. PA Nurse Corps Orientation Course. This orientation course is a three (:3) week course conducted by the Office of the Army Chief Nurse to all Nurse Corps officers newly assigned PA. This course is designed to acquaint the nurse to the basic rudiments of military organization particularly the Philippine Army.

b. Technical Service Officers' Basic Course - The Technical

Service Officers' Basic Course (TSOBC) is a 16 week course conducted by the PA TRADOC. Its objective is to provide basic military training to all military officers belonging to the Technical Service so that these officers will have a working knowledge of the duties and responsibilities expected of them in the military service. This training consists of two (2) phases. The Military Phase is an eight (8) week course conducted at PA TRADOC, The Specialization phase is an eight (8) week course conducted at the Armed Forces of the Philippines Medical Service School (AFPMSS) (for the Nurse and Medical Corps officers only), in AFP Medical Center.

1) Prerequisites.

(a) No pending administrative and/ or criminal case

before any Efficiency and Separation Board, Civil Court or Court Martial. (b) Must not be due for reversion.

(c) Must not be pregnant (for female)

(d) Physically and mentally fit.

c. Technical Service Officers' Advance Course. This course is a 16

week course conducted at the PA TRADOC. It is designed to provide Technical Service Officers the knowledge and skills in staff procedures and functions to qualify them to staff positions which correspond to their rank and to expose the Army Nurse Corps officer to the concepts of management

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which are considered necessary tools in policy formulation and decision making process.

1) Prerequisites:

(a) A graduate of Technical Service Officers' Basic Course

(b) Must be physically and mentally fit

(c) Must be available for full time training

(d) No pending civil, administrative, criminal or court-martial case; and

(e) Not due for reversion/retirement during the period of training.

d. Personnel Officers' Course - This course is a twelve (12) week course offered at the PA TRADOC. It is designed to produce qualified administrative and personnel officers for the PA Nurse Corps.

1) Prerequisites

(a) Graduate of Technical Service Officers' Basic

Course (b) Rank of Captain

(c) No pending civil/administrative/criminal or court

martial case;

(d) Not due for reversion; and

(e) Must possess above average aptitude for administrative functions 3. High Level Courses

a. Command and Staff Course/Technical and Administrative Service Command and Staff Course (TASCSC). This is a 24 week course conducted at the Armed Forces of the Philippine Joint Command and Staff College (AFP.JCSC). It is designed to prepare Technical Service senior officers for the various troop commands and staff positions in the AFP.

1) Prerequisites:

(a) Graduate of Technical Service Officers' Advance

Course with the rating of 85% and above

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(b) Must have occupied a position calling for the rank of 0-4 for at least one (1) year

(c) Must have no pending civil, administrative, criminal or court martial case; and

(d) Must have current security clearance for access to at least "secret" documents/materials

(e) Must have at least five (5) more years of service before compulsory retirement after the completion of the course.

(f) Must be physically and mentally fit

(g) Must pass the required entrance examination

b. Master in National Security Administration. This is a one (1) year post graduate course conducted at the National Defense College of the Philippines leading to a degree of Masters in National Security Administration.

1) Prerequisites:

(a) Rank of field grade officer (b) Must be GSC eligible

(c) Must have at least five (5) or more years of service

before compulsory retirement after the completion of the course

(d) Must pass the qualifying entrance exam

(e) Must be physically and mentally fit

(f) Must be recommended by the Chief Nurse, AFP

Section 6-2 Professional Advancement Program

4. The 22-KIDA Program and Other Similar Grants

a. Nurse Corps Officers are given the opportunity to develop their potentials through the acquisition of knowledge and expertise for career growth and development through the AFP scholarship program and other similar grants. This program is governed by Circular Number 4 MND dated 01 September 1982.

b. Nurse Corps officers who are grantees under Section 22K NDA

and other similar grants are allowed to pursue graduate or post graduate studies in certain academic disciplines in certain local educational institutions

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to be periodically determined by the Higher Headquarters. These courses should be geared towards the attainment of AFP I unit's goals and objectives.

1) Prerequisites

(a) Must have been in the active service for at least

five (5) years; (b) Must not be due for retirement within five (5) years

or during the period of mandatory service after the completion of study.

(c) Seniority

(d) Job performance based on the three (3) most recent evaluation by three (3) different raters with rating of very satisfactory

(e) Awards and decorations covered by appropriate orders

(f) Must not have availed of previous scholarship grants

(g) Must be recommended by the Office of the Army Chief Nurse.

2) Application shall include

(a) Statement of circumstances of the candidate to include name, rank, AFPSN, date of birth, effective date of present rank, length of government service (military and civilian separately indicated), and statement of educational qualifications, outstanding academic achievements and related accomplishments.

(b) Course Duration (in number of semester/ trimester/

summer sessions)

(c) A transcript of records for all Collegiate Courses completed or partially completed

(d) A statement as to the nature of any scholarship (full or partial) previously granted the candidate.

(e) A statement of the future utilization of the candidate, relating the education or training to be acquired with the future assignment.

3) Utilization

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After completion of the course; the grantee shall be assigned to units/positions in line with or allied to the course pursued for such period of time as may be deemed most beneficial or advantageous to the service or where he may be assigned/tasked to do a staff study on any major problem of the AFP wherein his new knowledge will be utilized.

5. Local Schooling in Civilian Schools. The Philippine Army shall pay for the tuition and school fees only, subject to the usual accounting and auditing procedures.

a. Qualifications: an applicant must have the following:

1) Must not be due for compulsory retirement within the period of contractual service;

2) Must not be enjoying any similar scholarship or

educational assistance grant from the AFP or any government entity;

3) Must not have any pending administrative and/or criminal case before any Efficiency and Separation Board, civil court or court martial;

4) Should not be serving contractual service because of a previous scholarship grant;

5) Must possess the appropriate educational qualifications; (6) Must have good scholastic standing;

6) Must have a performance rating of at least very satisfactory for the last three (3) years

7) Seniority

b. Grantees may enroll in any state university or school to be approved by PA Selection Board for Local Schooling.

c. Grounds for termination.

1) If the grantee is discovered to be a beneficiary of a similar

scholarship program sponsored by the AFP or any government entity; 2) Failure to meet the prescribed academic standards

3) Voluntary withdrawal from the course by the grantee.

4) Non submission of grades before the start of the next

semester

d. Contract/Mandatory Service. Any officer detailed to study under the provisions of Circular Number 4 MND dated 01 September 1982, shall prior to enrollment, execute a written promise to serve the Armed Forces of

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the Philippines for a prescribed period of mandatory service (number of years for every year of study or a fraction thereof but not less than two (2) months) based on the degree of financial support or assistance/scholarship given by the government. (Figure 6-1)

Contract of Mandatory Service

Table 6-1

Source of Funds Period of Mandatory Service 1. Government Funds

a. Local Schooling b. Schooling Abroad

2.5 years 3 years

2. Private Institutions (no funds involved other than salary/allowance) a.. Local Schooling b. Schooling Abroad

2 years 2.5 years

6. International Military Education and Training Program (IMETP). It is a training program open to all military personnel on active duty. This training is under the Mutual Aid Program of the United States Armed Forces.

a. Criteria for Foreign Training.

1) Previous training and experience- Only those with excellent performance in the previous schoolings both civilian and military shall be recommended;

2) Level of schooling - age, rank, past and present

assignments shall be considered;

3) Equity of the alternate - an officer selected as alternate for a course becomes the principal for the same course the next time it is offered, unless he is no longer qualified.

4) Age limit -younger officers shall normally be given preferential consideration.

5) Frequency of Schooling - no military personnel shall be considered for another foreign schooling until he has completed a time interval between schoolings as follows:

Frequency of Schooling Table 6-2

Previous Course Duration Time Interval

1) Eight (8) week to 6 months 2) more than 6 months to 1 year

3 years 4 years

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3) more than 1 year to 2 years 4) more than 2 years

5 years 6 years

6) Career Personnel- career personnel with long expectancyfor continued service shall be given priority for consideration for foreign training. However, if there are no career personnel who are qualified and/ or available for particular courses, deserving reserve Nurse Corps officers who fall under the purview of Section 3 RA 2334 may be considered for the course.

7) Only military personnel assigned Phil Army will be considered in the selection of candidates;

8) Training in foreign schools should complement military

education received in local schools. It should not duplicate training previously received.

b. Mandatory Prerequisites.

1) Must have completed at least three (3) years of active service in the Phil Army.

2) Satisfy rank requirement of the school catalog

3) Have completed prerequisite course(s) if required

4) Have completed the required time interval, if applicable

5) Have not taken the same or similar (in scope) course in

local service schools.

6) Have at least five (5) more years of service before compulsory retirement after the completion of the course thereof

7) Have no pending case before any military/civilian courts/boards and other investigating agencies.

8) No property and money. accountability/responsibilities

9) Have appropriate security clearance for schooling abroad pursuant to the provisions of AFOR G 200-52 or appropriate clearance required of the students by the recipient school.

10) Be academically qualified to excel on the coursecontemplated, and not merely to pass it.

11) Have passed the ALCPT and or ECI Test! Applicable to 2LT/ENS up to Major/LCDR. Except for health courses where officers up to LTC/CDR are required to take the test.

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c. Selection Procedures.

1) A Selection Board for Foreign Schooling in the Phil Army shall be created. The Chief of Staff, PA will head this board.

2) The Board shall screen and rate all qualified candidates

in a prescribed rating form. However the action offices/ units may devise their rating scale. In case two or more candidates obtained the same ratings, the most senior shall be selected.

3) To insure the filling up of training spaces a principal and alternate shall be selected for each space. When there are two or more spaces, the candidates shall be recommended in the order of priority.

d. Utilization. After completion of a course, the graduate shall be

assigned/placed DS in AFPWSSUs/Major Service Primary Training unit as an instructor or in field staff positions where maximum utilization can be made of the training received for a period of at least one (1) :year.

Section 6-3 In-Service Training Program

7. Components of the Human Resource Development Programs

a. In Service Training Programs.

1) Job Induction/Orientation. This type of in service training program is designed to equip the newly assigned Nurse Corps officer/personnel to the PA Nursing Service with the basic organization information needed to adapt to the work situation. It has the following components:

(a) Orientation to the HPA. The following may be

included but not limited to:

(1) HPA orgn and objectives/mission/goals

(2) Philosophy of HPA

(3) Functions of the different staffs

(b) Orientation to tile Office of the Army Chief Nurse (OACN) and other Health Service component. May include the following but not limited to:

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(1) Organization, Objectives, Mission, Goal, Vision and Philosophy

(2) Functions of the different staffs

(c) PA Nursing Services

(1) Historical Background and Organization of

General/ Station Hospitals and Medical Infirmaries. (2) Functions of Staff and Personnel of

General/ Station Hospitals and Medical Infirmaries

(d) AFP Regulations/Command Policies

(1) Uniform (2) Leaves: Local and Abroad ill. Maternity

Leaves/Report of Pregnancy

(e) PA Nursing Services Policies/ SOP’s

(1) Admission/ transfer in-out/ discharges (2) Referrals/ Consultations

(3) Death

(4) Medication Policies

(5) Staffing/ Assignment of Mil and Civ

Employees

(6) assigned Nursing Service

(7) Policies affecting Military Civ Employees assigned Nursing Service

(8) Government Hours (9) Leaves

(10) Legal Responsibilities of Mil Civ Employees

assigned Nursing Service.

(11) Nursing Records and Reports

b. Skills Training Program. This training program is designed to develop the competence of the Nursing Service care givers in order to improve their efficiency and performance.

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c. Leadership Training. This training designed to prepare senior

Nurse Corps officer for supervisory positions and level management and enhance the capabilities of those already on the job.

8. In Service Education Provides To All Military And Civilian Employees Assigned Nursing Service With The Opportunity To Learn How To Perform Effectively And Efficiently.

a. The quality of nursing care rendered by the nursing service care giver is dependent on their knowledge, skills and attitudes (KSA). There is

b. Need for an effective human resource development program

because of the rapid turn-over of Nursing Service personnel, the continuous implementation of service and technology as well as the social cultural changes and the unpredictable patterns on morbidity and mortality.

c. Human Resource Development (HRD) provides for a continuing education that will fully develop the care givers' potentials. This includes:

1) Orientation 2) In service training programs

3) Conferences

4) Seminar/workshops

5) Book clubs

6) Case presentation

7) Journal readings

d. Human Resource development is the responsibility of both the

Chief Nursing Service and the care giver concerned. In the planning of the program the nursing service care givers should be involved so that the program will be responsive to their needs. General/Tertiary hospitals with training capabilities should have the Nursing Service Education and Training Branch. It will be the responsibility of the training staff together with the Chief Nursing Service for the planning, implementation and evaluation of the program. Attendance of the Nursing, Service care givers to the programs should be a must and should be made on rotation basis to give equal opportunities to all the nursing service care givers. 9. Factors to be Considered in the Development of an the Service Education Program

a. Identification of the learning/training needs of the nursing service care givers

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b. Course objectives

c. Course content

d. Selection of participants

e. Schedule of the training program (date and time and duration)

f. Choice of the venue for the training program (1) Adequately

spaced room (2) Well ventilated and lighted - conducive for learning

g. Accommodation of the participants (for live - in seminars)

h. Accreditation of the training program

i. Selection of speakers

j. Availability of training facilities

k. Course evaluation

Section 6-4 Paramedical Training in Army Health Care Facility

10. General. GHQ Cir No. 18 dtd 7 Jun 71 provides for the Paramedical Internship Training for Medical Interns, Medical Technicians and Nursing Students in AFP Hospitals. For NC Officers assigned in PA health care facilities offering training to these paramedical trainees, it is their duty to help provide an environment conducive to learning in the respective wards or units. NC officers should coordinate and cooperate 'with the clinical instructors in supervising and giving spot instructions as needed to nursing students in their units. 11. Nursing Affiliates. The PA Nursing Service is guided in the management of nursing affiliates as per SOP No. 12 HPA dtd 26 Oct 76. Affiliates are students of nursing/midwifery health aides who are undergoing training internship with Army General/Station Hospitals as approved by higher headquarters while clinical instructors are professional nurses designated by the school to follow up and supervise nursing affiliates. 12. Objectives

a. To assist in and facilitate initial orientation of both student nurses/midwives and their clinical instructors to military environment;

b. To provide guidance and assistance to bring about uniformity

and correlation of experience of all student nurses regardless of school and college; and

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c. To serve as an effective tool in assisting the student to adjust to

the varying clinical situations they may encounter in Army Hospitals. 13. Policies. Affiliation for internship training is extended to educational institutions duly recognized by the government. A contract between the affiliating school and the designated military health care facility is approved by the Chief of Staff, AFP subject to the following conditions:

a. That the interest and welfare of the clients shall at no time be subordinated to the conduct of the affiliation training program;

b. That no special rooms or space be designated for the use of

students or by the hospital for the same purpose out of government funds;

c. That the rules and regulations prescribed by the different affiliating institutions for their respective training programs be coordinated first with the Commanding Officer of the military health care facility before they are implemented in the clinical area; and

d. That the military health care facility he provided with security clearance for each student and clinical instructor which can be obtained from the nearest intelligence agency within the area.

14. Policies and Regulations of the designated Health Care Facility

a. All newly assigned clinical instructors to PA health care facility with training capabilities shall undergo two week orientation program prior to their following up of students in the clinical areas.

b. All nursing and midwifery students who will be fielded in a PA

health care facility shall undergo a general orientation program once every year prior to their exposure in the clinical areas.

c. Student's schedule in the clinical areas shall be submitted to the Office of the Chief Nursing Service thru the Asst Chief Nurse for Education and Training Branch at least a week prior to scheduled duty dates.

d. Clinical instructors shall wear proper uniform (white dress, brown stockings and white shoes) when they are in the clinical areas.

e. Students shall only be admitted in the clinical areas upon presentation of a coordination slip signed by the Asst Chief Nurse for Education and Training or his authorized representative.

f. Billing of affiliation fees shall be given to the respective colleges one week prior to the end of their scheduled clinical exposure.

g. Plotting of master rotation plan in the clinical areas shall be done once a year

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h. Nursing/ Midwifery students scheduled for DR/Nursery duty shall

undergo throat swabs as precautions.

15. Responsibilities of the Clinica1lnstructors

a. Clinical Instructors are appointed by their respective College/School of Nursing. Their professional competence to follow up and supervise the students is the school's responsibility;

b. Clinical Instructors are required to sign in and out at the Office of

the Chief Nursing Service everyday during their tour of duty;

c. Clinical Instructors are supposed to undergo two week period of familiarization and orientation in his specific area of assignment before be is allowed to follow-up students in the health care facility;

d. Clinical Instructors are directly responsible for the learning experience and performance of students while on affiliation with the hospital. Therefore, their duties and responsibilities include the following:

1) Together with the head nurse, plan and prepare students

assignments where they can put into full practice what they have learned in the classroom;

2) Plan, supervise, guide and give instructions in the form of

ward classes, ward conferences, nursing rounds or bedside clinics;

3) Prepare programs of activity that would help develop right attitudes of the students as well as enable them to acquire skills in giving appropriate nursing care;

4) Evaluate the student's strengths and weaknesses and find out ways to improve their overall learning experience;

5) Final evaluation of students' performance is primary responsibility of the clinical instructor, however, this may be done jointly by the head nurse and clinical instructors;

e. Clinical instructors are responsible for the behavior of their

students and any misconduct should be reported to the Chief Nursing Service, who in turn shall refer the matter to the School Authorities for appropriate action;

f. Attendance in all students' dialogue, clinical instructor head

nurse conferences and other professional activities of the health care facility especially of the nursing service is a must for clinical instructors; and

g. Set an example of good professional decorum for student to take as. a model.

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h. Observe secrecy discipline at all times when inside the camp.

16. Responsibilities of Students.

a. Students should observe their duty hours specified in their Assignments and schedules prepared by their respective schools. Tardiness or absences should be dealt with in accordance with the policies of the particular school.

b. Courtesy and mutual respect towards clients, visitors and

hospital care giver should be observed at all times. While kindness and friendliness are excellent virtues, familiarity and intimacy with any of the above persons should be carefully avoided.

c. Social visits or attending to personal activities during duty hours is not allowed except when extremely necessary and prior permission has been secured from their clinical instructors.

d. Students are expected to behave like ladies and gentlemen observing the unwritten rules of ethics and proper decorum at all times.

e. Gambling, drug and alcohol intoxications are strictly prohibited and may be punishable if found guilty.

f. Students are not allowed to accept gifts or presents from clients and/or relatives of clients.

g. Bringing playing cards or radio for self amusement of clients is not allowed.

h. Observe utmost courtesy in answering calls, the telephone in the ward is strictly for clinical business only.

i. Observe secrecy discipline at all times when in the compound. Do not issue any information or give out statement to the press and to unauthorized persons about any clients or activity in hospital.

j. Refrain from giving out undue comments or advice to clients and their relatives about illness or prognosis which may adversely affect their mental or emotional disposition.

k. Safety measures should be observed at all times to prevent loss or injury not only to the clients but also to the visitors, and care givers of the health care facility. Existence of firearms at the client's bedside should be reported at once to the head nurse.

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l. Coffee breaks and snacks are allowed for 30 minutes; however, students shall ask permission from the head nurse or clinical instructor before leaving.

m. Cooperate in the enforcement of the hospital rules and regulations such as visiting hours, cleanliness of surroundings and proper use of toilets and washrooms.

n. Be properly equipped with basic nursing tools (scissors, wristwatch with second hand and red/blue pens). Avoid displaying excessive use of jewelries and large amount of cash.

o. Proper use of hospitals supplies and equipment should be observed. Students will be required to replace in cash or in kind breakages or loss of hospital supplies and equipment due to carelessness and negligence unless justified otherwise in writing.

p. Students must be acquainted with policies affecting Nursing Service care givers and practices of the ward or area where they are assigned. Students and clinical instructors have no jurisdiction over any professional/non-professional Nursing Service care givers of the ward. Relationships with the care givers are on a coordinative basis. Any complaints against them should be made to the Chief Nurse thru the head nurse if this could not be resolved in area.

q. It is the responsibility of the student to complement experience by reading and discussing for profundity of knowledge.

17. Phases of the Instructional Programs.

a. General Orientation Phase. It is to acqu8Lflt student affiliates and clinical instructors with general information on the institution, and other standard information applicable to all clinical areas of the hospital. Activities would include a briefing and physical tour of the hospital;

b. Unit Organization Phase. This phase is usually conducted by the

head nurse of the unit. It is: to acquaint the student nurse of her role in a particular unit and how she can function as part of the health care service team. Orientation on the physical set.-up of the ward includes introduction to inter-relationship of student nurses and staff;

c. Student Development Phase. This is usually accomplished by means of the follow-up and supervision of the clinical instructor in order to assist the student nurse to gain experience and skills in her application of classroom theory to clinical activities and/or cases. Activates are dependent on the daily plan of activities and specific objectives of the clinical instructor and the student nurse; and

d. Evaluation Phase. Submission of affiliation evaluation reports by student nurses and conferences among clinical instructors, student nurses

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and the Assistant Chief Nurse for Education and Training (or equivalent) is undertaken. Above reports and conferences are to measure experience gained by the students against their particular objectives. Discover existing problems which might have been overlooked; and suggestions which may add to their solutions.

18. General Requirements.

a. There should be an organized training program of affiliation prepared by the health care specificity in consultation with the affiliating College of Nursing;

b. The Asst Chief Nurse for Education and Training (or equivalent)

shall be responsible for the implementation of the training program for nursing affiliates

c. The training shall include the following:

1) Course Objectives 2) General learning objectives

3) Course Contents

4) Syllabus

5) Methodology

6) Schedule

7) Monitoring and Evaluation

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CHAPTER 7 CONDUCT AND DISCIPLINE

Section 7-1 Standards and Policies

1. Nursing Service Policies. Policies are guidelines or fundamental bases that dictate all actions of both military and civilian employees assigned Nursing Service in the performance of their duties and responsibilities. Policies are formulated to accomplish predestined objectives. All those affected and covered by policies should participate in the preparation and formulation of the policies. Policies should be approved by the approving body and when approved should be written down, reviewed, updated and revised if needed.

a. Forty Hours Work A Week. All Nursing Service civilian employees assigned in any PA health care facilities are required to render eight (8) working hours a day for five (5) working days a week or a total of forty (40) hours a week exclusive of time for meals. (CSS Res. No. 91-671 dtd June 1991).

b. Time In/Time Out. All Nursing Service civilian employees shall

record their daily attendance on the proper form or whenever possible, have them registered on the Bundy clock. Any other means of recording attendance may be allowed provided their respective names and signatures as well as the time of their arrival to and departure from office are indicated, subject to verification. The record of attendance which shall be kept in a conspicuous place shall be in the custody of a responsible person who will monitor their arrival and departure. Offsetting of tardiness or absences by working the equivalent number of minutes or hours by which a civilian nursing service employee has been tardy, beyond the regular or approved working hours of the employee concern shall not be allowed.

c. Absenteeism and Tardiness.

1) Habitual Absenteeism

(a) A civilian Nursing Service employee shall be considered habitually absent if he incurs unauthorized absences exceeding the allowable 2.5 days monthly leave credit under the leave law for at least three (3) months in a semester or at least three (3) consecutive months during the year.

(b) Any civilian nursing service employee shall be

considered habitually tardy if he incurs tardiness, regardless of the number of minutes, ten (10) times a month for at least two (2) consecutive months during the year.

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(c) Tardiness and under time are deducted against vacation leave credits and shall not be charged against sick leave credits unless the under time is for health reasons supported by medical certificate and application for leave. (Provided under CSC MC Nr. 41, s. 1998).

(d) A civilian nursing service employee shall not be entitled to receive his salary corresponding to the period of his unauthorized leave of absence. It is understood, however that his absence shall no longer be deducted from his accumulated leave credits, if there are any (Amended CSC MC Nr 41 s. 1998).

(e) Absence on a regular day for which suspension of work is announced. When a civilian nursing service employee fails to report for work on a regular day for which suspension of work was declared after the start of regular working hours, the personnel should not be considered absent for the whole day. Instead he shall only be deducted leave credits or the amount corresponding to the time when official working hours start up to the time the suspension of work is announced.

(f) Leave of absence without pay on a day immediately preceding or succeeding Saturday, Sunday or Holiday. When the employee regardless of whether he has leave credits or not, is absent on a day immediately preceding or succeeding a Saturday, Sunday or Holiday whether such absence is cotillions or not, he shall not be considered absent on said Sundays and Holidays and shall not be deducted leave credits. He shall neither receive salary for those days (Amended CSC MC Nr 41, s 1998.)

Section 7-2 Nursing Activities in the Ward

2. Oral Endorsement

a. It is an oral report by the outgoing shift to the incoming shift on the significant evaluation of each patient's condition in the nursing unit. It is the transfer of responsibilities from one shift to the other for the purpose of achieving continuity of patient care.

b. It is done at least fifteen (15) minutes before the shifting time,

however for areas which require longer time, endorsement is done 30 minutes before the shifting time.

c. All nursing personnel should join the endorsement. They are required to have a small notebook to note down important data received during the endorsement.

d. What to endorse in the endorsement sheet:/notebook.

1) Pertinent orders to be followed up for each client. Particularly new orders in medications, laboratory exams and others.

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2) Expected transfer in-out of the units, discharges

3) Articles to be changed or repaired

4) Non-functioning, missing or bon-owed equipment and

from whom

5) Critically ill clients, sudden changes in their condition, death of clients.

6) Any nursing errors reportable to the head nurse/supervisor.

7) Latest vital signs of febrile/ cardiac clients

8) Latest assessment of client's condition

9) Orders not carried out during the shift

10) Information to be relayed to doctor

11) Time schedule of' surgery and brief pre-op checklist

12) Other pertinent information. 3. Nursing Rounds. Activities wherein nurses who received the oral endorsement assumes responsibility of clients, visiting all of the clients briefly before the start of the shift, assessing each client's particular problems as basis for meeting his/her needs. During these rounds nurses give special attention to the critically ill, the post-op and newly admitted clients. This nursing round is important guide in the planning, executing and evaluating the Nursing Care Plan (NCP).

Section 7-3 PA Nursing Service Personnel Discipline

4. General. Technique of controlling an employee's behavior is by enforcing sanctioned/approved disciplinary procedures. All military and civilian employees assigned Nursing Service believe that discipline is a form of self control through which the individual's cause is in accordance with the nursing service code of behavior while the supervisor believes that discipline is the process of bringing about their compliance with the rules and regulations of the Nursing Service. 5. Military Nurses Code of Conduct. Our military establishment is governed by rules and regulations which emanate from four (4) sources;

a. Laws of Congress.

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b. Army Regulations and other Directives.

c. Presidential Directives.

d. Code of Practices as custom of the service.

6. Many of the traditions, customs and courtesies of the AFP are written down as Army Regulation. Customs of the service are the long established practices or usages of constant and repeated observance, acquired the character of unwritten norms of conduct. Despite the possible changes in customs to suit the needs of modern living, these established precedents remain as the minimum accepted practices in the military. The following Code is issued to provide our officers with an official guide on military behavior.

a. Courage, Loyalty, and Integrity - Have faith in God, in the greatness of your God and in the capacity of your people. Act at all times in accordance with the call of courage, loyalty, and integrity.

b. Officers Speech - Avoid profane and obscene language in your

utterances. He who swears or indulges in blasphemy exhibits his inability to express himse1f forcefully in proper language and betrays his lack of decency and se1f-control.

c. Sanctity of Official Statement. - Do not lie, quibble, or make

evasive statements. An officer’s official statement, whether written or oral, should be so sacred as to be accepted without question.

d. Servility Is Scored. - Avoid servility and bootlicking. Deliberate courting of favors is below the standards of conduct expected of officers. He, who stoops to these reprehensible acts, whether openly or covertly, debases himself and incurs the scorn of his associates.

e. Depending upon Oneself - Rely upon yourself, your ability and personality. Keep rank and authority in the background. Take pride in your men, maintain ideal friendship with them, and derive satisfaction from their work. Be a leader who inspires and not a boss who exasperates.

f. Leaning of Rank. - Do not lean on your rank in your actuations. If you are on the top level, do not brag that you are on top of a mountain. Instead, strive to place yourse1f in such a position that you could sense and feel the feelings of those above and below you.

g. High Morale Character. - Lead an honorable and upright life.The officer by virtue of his position is responsible for regulating the moral life of those under him. On occasions, he is called upon to punish them for moral lapses. He cannot do this honestly and justly unless he himself possesses a moral character which is beyond question.

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h. Consideration for Others - Be considerate of the feelings of others no matter what their station in life may be he who licks the boots of those above him and kicks the faces of those below him on the social ladder, is an illustration of what a gentleman is not.

i. False Standards. - Avoid spending excessively to maintain false standards beyond your means. You are not expected to make an expression in the matter of spending money. It is enough that you do not disgrace the uniform.

j. Borrowing Money. - Never incur indebtedness, except in extremely unavoidable circumstances. If you have incurred debt, remember it is a debt of honor which must be paid without fail and as promptly as possible.

k. Courtesy. - Be courteous to subordinates. It is as important as courtesy to superiors.

l. Punctuality. - Be punctual in all your engagements. Remember that punctuality is the courtesy of leaders.

m. Respect. - Pay the same respects to officers of the Armed Forces of other nations, and to officers of the Reserve Force, when in uniform, as those rendered to officers of the Armed Forces of the Philippines.

n. Cheap Places. - Avoid cheap places. It is disgraceful for officers to visit cheap places, such as questionable houses and untidy restaurants, especially while in uniform.

o. Officer's Uniform: The uniform identifies the wearer as a member of the Armed Forces of the Philippines; Officers are required to provide their uniforms and uniform equipment at their own expense. Uniforms are required to conform. In every respect to specification approved by General Headquarters.

1) The uniform will be kept clean, neat and in good repair. 2) Missing insignia will be promptly replaced.

3) Insignia and buttons will be bright Finished.

4) Overcoats, coats and shirts will be worn in regulation

shape.

5) Service hats will be worn in regulation shape.

6) No civilian decoration, watch chain or other jewelry will be exposed on the uniform.

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7. Officer's Code

a. The Code of Duty well performed, of Honor in all things, of Country above self is the unwritten 1m", on which the official acts of officers of the entire army are based.

b. Any Officer's official word is his bond, and is accepted without

question.

c. Every officer, on active duty or in a civilian component must always be ready for a greatly increased responsibility.

d. Every officer must work toward maximum efficiency and must provide effective leadership, impartial justice, and a wise human interest in his men.

e. An officer who provides for his men need never fear for his own well being or conduct.

8. Attributes of Rank: The responsibilities that go with rank and experience naturally produce certain rights and privileges.

a. It is customary for juniors to yield to their seniors. This is not servility. It is poor taste in any walk of life for junior to rush pell-mell ahead of a senior.

b. It is a violation of common courtesy for juniors to seize the best

accommodations.

c. When a CO states that he v;,'1shes or desires that something must be done, his desire has all the force of an order.

d. The word "Sir" is used in military conversation by a junior addressing a senior.

e. The salute is not only a gesture of greeting, but also an expression of mutual trust and respect.

f. Courtesy Call - The matter of making calls on the post commander has sometimes perplexed junior officers about to enter the service.

1) An officer arriving at a station, whether for duty or for a

visit longer than 24 hours, must call on the CO at his office without delay. 2) One of the oldest customs of the service is that all officers

of a unit or a garrison shall call on the CO on New Year's Day.

g. Walking Outdoors

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1) For military personnel, when two officers are walking together the junior watch’s on the left of the senior and keeps in steps with the senior setting the pace.

2) When overtaking, a senior pass to the left if possible,

(otherwise to the right) salute and say "By your leave, Sir/Ma'am.”Do not proceed until the senior says, "Carry on."

h. When opening doors junior officer opens a door for his or her

senior, stands aside for the s senior to pass through then follows. i. At the change encounter with a senior or ranking person, one

should not feel obligated to pay for lunch or dinner of the other.

j. Introductions

1) An officer is always presented to a lady regardless of his rank with the exception of the president of any country, a king or dignitaries of the church.

Example: "Mr President, may I present Ms. Cruz" or "Mrs.

Cruz, may I present General Saludo.”

2) The higher making military person's name is stated first then the name of the military\ person being presented.

Example: "Gen Saludo, Sir, may I present Maj Castro.”

3) Younger people are presented/introduced to older people

of the same sex.

Example: “General Saludo, may I present Major Cruz?” (Mr Saludo is older than Mrs. Cruz) or “Mrs. Cruz, this is may daughter, Eva.”

k. In the Military Service, a junior officer at official or very important

functions ,guest of honor or the high ranking or most senior officer/ guest leaves. However, the junior officer or anyone who reason to leave before the guest of honor should explain such to the host before departure.

l. Senior officers should be addressed by their title and name

rather than by the impersonal "Sir" or "Ma'am". A sign of respect to military seniors will him automatic by saying "Sir" or "Ma'am", thank you for the gift. Seniors should never forget that they are exemplars to their subordinates by treating respectfully everyone they come in contact with.

m. Handshake should be brief with a feeling of strength and warmth

in the clasp and by looking into the face of the person shaking hands with. Gentlemen shake hands whenever they are introduced or taking their leave with the senior making the first move. A man usually waits until an officer her hand before extending his hand.

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n. When in civilian dress, military' personnel should stand at

attention, place their right hand over their hearts whenever the national anthem is played.

o. Military courtesy in cars. The senior officer enters last and the

junior enters first. The senior officer sits on the right and accorded the most desirable scat. If three persons are seated at the back seat, the most junior is at the middle. When the car is full, the most junior sits in front.

9. Military Discipline.

a. Military Discipline is a state of order and obedience existing within the command. It involves ready subordination of the will of the individual for the good of the group. Discipline demands habitual but reasoned obedience to command, an obedience that preserves and functions unfalteringly even in the absence of command. Discipline is instituted in accordance \with AFP Code or Discipline, Letter Directive from CS, AFP dtd 14 Mar 83 and AFP Regulations G 131-013 DND dtd 24 Sep 87 through:

1) Training. 2) Judicious use of punishments Had reward.

3) Instilling a sense of confidence and responsibility in each

individual.

4) Discipline is best inculcated on an individual by appealing to his sense of reason. In instance’s \where appeal to reason fails, the use of punishment is effects in causing the recalcitrant individual to conform and perhaps appreciate the need of discipline.

5) Commendations and earned! Praise from the senior to his subordinates either individually or collectively for a task well done; serve to strengthen the disciplinary bonds which bind together the smooth functioning team.

6) In dealing with civilian populace, populace should be in conformity \with the ideal norm of social behaviors, designed to win the confidence and support of the people of the AFP,

b. Discipline is developed by'

1) Assigning subordinate’s specific duties, with responsibilities and authority commensurate with their capabilities on the job.

2) Not demanding more of subordinates than they are

trained to give.

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3) Being subordinates Understand exactly what is expected of them and ensuring that they do what is assigned them

4) Standardizing procedures as tar as possible

5) Ensuring that the subordinates know the system of rewards and punishment

(a) Rewards commendation, job satisfaction, other privileges, promotions and others

(b) Punishment group censure, admonition,

punishments under Article of War 105, Court Martial, demotion, and others.

(c) Rewards and punishments must be carefully and skillfully handled for best results

(d) Rewards and punishments must be administered equitably and constructively

6) Building discipline deliberately and progressively.

7) Giving extensive practice in desired behavior to order to develop habits of ready obedience to commands

8) Fostering "unit opinions" so strong that men will not

hesitate to conform to them.

9) Some occasions in which disciplinary action may be taken:

(a) Abuse of military personnel (b) Misconduct while on leave/furlough

(c) Abuse or inordinate display of wealth

(d) Arrogance, recklessness and discourtesy in driving

(e) Drunkenness

(f) Unauthorized carrying and indiscreet displaying of

firearms

(g) Absence without Leave (AWOL)

(h) Frequenting premises of places of ill repute

(i) Improper wearing of uniform

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(j) Rumor mongering and spreading wrong information

10. Guidelines in the Exercise of Military Authority

a. Military authority shall be exercised with promptness, firmness and justice;

b. Trial by Court Martial, Administrative proceeding or punishment

under Article of War 105 shall not be resorted to in cases of trivial offenses; except when less drastic methods of discipline have been tried but without results (offenses which have been corrected when brought to the attention of the officer concerned shall be considered as closed incidents and need not to be noted on the offender's records.)

c. Superiors should avoid any display of anger or administer reproof when dealing with their subordinates in the presence of their juniors.

d. It is the duty of every superior to assist in the preservation of good order and discipline in the service. The superior is responsible for any negligence or impropriety observed by them among subordinates whether on or off duty.

11. Nursing Service Civilian Employees Code of Conduct. The Civil Service Commission Memorandum Circular No. 30 series of 1989, classifies administrative charges as "grave" and "light" and provides for the corresponding penalties. Administrative offenses with corresponding penalties are classified into grave, less grave or light, depending on their gravity or depravity and effects on the government service. 12. Grave Offenses with Dismissal as the Penalty on First Offense:

a. Dishonesty.

b. Gross neglect of duty. c. Grave misconduct.

d. Being notoriously undesirable.

e. Physical or mental incapacity or disability due to immoral or

vicious habits.

f. Falsification of official document.

g. Receiving for personal use of a fee, gift or other valuable things in the course of official duties or in connection therewith when such fee, gift or other valuable thing is given by any person in the hope or expectation of receiving a favor or better treatment than that accorded to other persons.

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13. Grave Offenses with the Corresponding Penalties of:

a. 1st Offense - Suspension (6 months & 1 day to 1 year) b. 2nd Offense – Dismissal

1) Oppression 2) Disgraceful and immoral conduct

3) Inefficiency and incompetence in the performance of

official duties

4) Frequent unauthorized absences or tardiness in reporting for duty, loafing or frequent unauthorized absences from duty during regular office hours.

5) Refusal to perform official duty

6) Gross insubordination 14. Less Grave Offenses with the Corresponding Penalties of:

a. 1st Offense -- Suspension (l month & 1 day to 6 months) b. 2nd Offense – Dismissal

1) Simple neglect of duty

2) Simple misconduct 3) Gross discourtesy in the course of official duties

4) Violation of existing civil service law and rules of serious

Nature

5) Insubordination

6) Habitual drunkenness

7) Unfair discrimination in rendering public service due to party affiliation or preference

8) Failure to file sworn statements of assets, liabilities and

net worth, and disclosure of business interest and financial connections including those of their spouses and unmarried children less than eighteen (18) years of age living in their households.

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15. Light Offenses with Corresponding Penalties of:

a. 1st Offense - Reprimand b. 2nd Offense - Suspension

c. 3rd Offense - Dismissal

1) Discourtesy in the course of official duties 2) Violation of reasonable office rules and regulations

3) Frequent unauthorized tardiness (Habitual tardiness)

4) Gambling prohibited by law

5) Refusal to render overtime service

6) Borrowing of money by superior officers from

subordinates

7) Lending money at usurious rates of interest

8) Failure to attend to anyone who wants to avail himself/herself of the spouses of the office or act promptly and expeditiously on transactions 16. Principles of Discipline

a. Discipline should be administered promptly, thoroughly, consistently, and non punitory.

b. Discipline should be progressive in nature and should be

preceded by counseling.

c. Disciplinary procedures should be instituted with extreme caution because of some extremely serious consequences for the employee.

17. Disciplinary Action. Problem solving efforts may significantly minimize if not totally eliminate future employee discipline infractions, however, in some instances, these efforts may no longer be effective. At this point, a disciplinary action should be taken. The sequence of steps under "progressive" or "corrective" discipline is as follows: (Figure 7-1)

a. Oral Warning. It should be conducted in an informal atmosphere to encourage the employee to relate his view of the problem with an opportunity for a reasonably complete statement of the facts the way the employee sees the problem. During the discussion, the supervisor may ask questions, however, if possible, avoid interrupting the employee. It is important to obtain all relevant facts. After all the facts have been gathered,

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analyzed, and evaluated against the employee's past records, the employee _should be informed of the supervisor's determination. This includes any expected improvement in future behavior assistance, if appropriate; disciplinary penalty (if any) being imposed and others.

b. Written Warning. It is the second step and is preceded by an

interview similar to the oral warning type discussion (Disciplinary Conference) at the end of the conference the employee is informed that a written warning will be issued. The statement of the problem, the rule which was violated, consequences of continued deviant behavior, and the employee's commitment to make corrections (if any) and any follow-up action that may be taken should be included in the written warning.

c. Suspensions. Suspensions can only occur for minor discipline violations after there has been record of oral and written warnings established. Suspension can be applied even in the absence of oral and written warnings if a major disciplinary infraction has occurred. Suspension, instead of dismissal is used by the Chief Nurse when he feels that there is still some hope for "rehabilitating" the employee.

d. Dismissal. The move to discharge/dismiss/terminate the, employee should only be invoked, when all problem solving and disciplinary efforts have failed. There should be accurate documented record of the oral and written warnings and suspension (if any) received by the employee. The Supervisor/Chief Nurse should be very sure that the reason for the termination conforms to the organization's criteria of a major discipline violation and that he can effectively support the case when needed.

Steps of Progressive Discipline

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CHAPTER 8 NURSES AND THE LAW

Section 8-1 Code of Ethics for Nurses in the Philippines (PNA Code for Nurses)

1. General. These fundamental concepts are in accordance with Sec 3 of RA Nr 877 and Sec 6 of PO Nr 223 dtd 1989.

a. Health is a fundamental right of every individual. Therefore, the nurses' primary responsibility is to preserve health at all cost. This responsibility encompasses promotion of health, prevention of illness, alleviation of suffering and restoration of health.

b. Basic nursing is knowledge and understanding of man. For

effective health care, knowledge of man's cultural, social, path physiological, psychological and ecological aspects of illness and the therapeutic process is essential. Differences in ethnicity, political, and social status are not barren to effective nursing care.

c. Standards of practice vary in different settings.

d. Respect for the rights and dignity of individuals is basic to the practice of nursing profession.

e. Society is ever-changing and the nurse responses to change. 2. Nurses and People

a. Values, customs, and spiritual beliefs held by individuals are to be respected.

b. Nurses hold in strict confidence personal information acquired in

the process of providing nursing care. Nurse discriminate judgment in sharing this information. 3. Nurses and Practice

a. Nurses are advocates of the clients. They take appropriate steps to safeguard the client's rights and privileges.

b. Nurses are aware that their nursing actions have professional,

ethical, moral and legal dimensions. They shave to perform their work in the best interest of all concerned.

c. Nurses are accountable for their own nursing practice. They are responsible for their personal and professional growth and development.

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d. Nurses observe personal and professional decorum at all times.

e. Nurses maintain or modify standards of practice within the reality of any given situations. Quality care is their goal. 4. Nurses and Co workers

a. Nurses maintain collaborative working relationships with their co workers and other members of the health team.

b. Nurses recognize their capabilities and limitations in accepting

responsibilities and those of their co-workers when delegating responsibilities to them.

5. Nurses and Society

a. Nurses are contributing members of society. They assume responsibilities inherent to being a member and citizen of the community / society in which they live or work.

b. Nurses recognize the need for change and initiate, participate,

and support activities to meet the health and social needs of the people.

6. Nurses and the Profession

a. Nurses are expected to be members of the nursing professional organization. Inherent in this responsibility is to support and uphold its constitution and by-laws.

b. Nurses participate actively in the development and growth of the

nursing profession.

c. Nurses help to determine and implement desirable standards of nursing practice and nursing education.

d. Nurses strive to secure equitable socio economic and work conditions in the nursing practice through appropriate legislation and other means.

Section 8-2 Scope of Professional Nursing Practice (R.A No. 7164 “Philippine Nursing Act of 1991)

7. Nursing Practice. In the Scope of Nursing - A person shall be deemed to be practicing nursing within the meaning of this Act when he, for a fee, salary or other reward or compensation, singly or in collaboration with another, initiates and performs nursing services to individuals, families and communities in various stages of development towards the promotion of

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health, prevention of illness, restoration of Health, and alleviation of suffering through:

a. Utilization of the nursing process, including assessment, planning, implementation and evaluation of nursing care shall be required according to Resolution No. 08 s. 1994 Sec 10 Art III of RA. 7164 which states that a registered nurse is prescribed or prohibited from administering intravenous injections to a patient unless he has undergone a special training at least under a nursing administrator who is a member of A.NSAP and who is qualified under Sec 28, Art V of R.A. 7164 thereon either before or after his registration as a nurse. By becoming aware of professional standards and laws related to administering IV therapy, the nurse can both provide the best care for clients and protect himself legally.

b. Establishment of linkages with community resources and

coordination of the health team;

c. Motivation of individuals, families and communities, resources, and coordination of services with other members of the health team;

d. Participation in the teaching, guidance and supervision of students in nursing education programs, including administering nursing services in varied settings, such as hospitals, homes, communities and the like; undertaking consultation service; and engaging in such other activities that require the utilization of knowledge and decision-making skills of a registered nurse; and

e. Undertaking nursing and health manpower development training and research and soliciting finance therefore, in cooperation with the appropriate government or private agency. Provided however, that this provision shall not apply to nursing students who perform nursing functions under the supervision of qualified faculty members.

Section 8-3 Nurse’s Legal Responsibility for Client Care 8. General. Every nurse is expected to care for patients within dreamed limits. If a nurse gives care beyond those limits, he becomes vulnerable to charges of violating the nursing practice law and will be held liable as stipulated in the Code of Ethics for Nurses in the Philippines 9. Negligence. One of the liabilities that a nurse may incur is the omission (not doing) or the commission (doing) of an act that a reasonably sensible person would or should not do under normal circumstances. Specific examples of professional negligence are:

a. Failure to properly administer drugs, treatment, medications and failure to report its adverse reactions

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b. Failure to exercise reasonable judgment in the performance of duty.

c. Failure to verity a subordinate's competence prior to the assignment of duty.

d. Failure to supervise subordinates.

e. Failure to record and report unusual behavior of clients.

f. Improper charting.

g. Failure to provide safety measures resulting in the injury of clients.

h. Inability to forecast possible harm to clients, such as in suicidal or psychiatric cases or from other elements.

i. Carelessness in applying hot water bag treatment and other nursing measures.

j. Allowing clients' easy access to medicine cabinets and sharp instruments.

k. Improper handling of equipment.

l. Loss of or damage to client's property.

m. Overlooking sponges, needles, and others. Inside the abdomen.

n. Escape of clients from the hospital

o. Leaving the unit without a reliever and proper endorsement. 10. Incompetence. Incompetence refers to a person's inability to perform a required duty. Although a nurse is registered if she manifests incompetence in the performance of her duty, her certificate of registration may be revoked or suspended. 11. Malpractice. Malpractice refers to the negligent act committed in the course of performing ones duties. For nurses, malpractice may come in the form of giving the client improper or unskilled care. 12. Res Ipsa Loquitur. Res Ipsa Loquitur means "the thing speaks for itself'. Three conditions are required to establish negligence under this doctrine:

a. The injury would not have occurred normally unless someone was negligent.

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b. The injury was caused by something within the exclusive control of the defendant.

c. The injured party did not contribute in any way to his injury ex., burns resulting from hot water bags, fractures, injuries sustained by the elderly, confused, unconscious or sedated clients.

13. Respondent Superior. Respondent Superior means "let the master answer for the acts of the subordinates". Under this doctrine, the liability is expanded to include the superior as well as the subordinate. It is not a shift of responsibility from the employee to the master. The employee still remains fully responsible for the act.

Nursing students take care of clients within their level of preparation. If the nursing student performs a task she is not capable of doing, the designated clinical instructor can be held liable.

Nursing supervisors/head nurses should likewise utilize competence

with corresponding authority as the basis for delegating responsibilities to subordinates. New and inexperienced nurses should therefore be under close supervision.

The supervisors/head nurses will be measured against the standard of

what a competent and prudent supervisor/head nurse does in the performance of his duties. Ward men, nursing attendants/aide, and institutional workers perform selected nursing activities under the direct supervision of the nurses. Their responsibilities usual]y pertain to routine care of chronically ill clients. After attending Courses on Basic Nursing Procedures conducted by the Nursing Service they are already liable for their own actions. However, if a nurse delegates her functions to the ward man, nursing attendant/aide and the latter commits a mistake, the nurse should be held liable for the mistake.

14. Liability of Nursing Attendants. Nursing attendants perform selected nursing activities under the direct supervision of the nurses. Their responsibilities usually pertain to routine care of chronologically-ill clients. The nursing attendants are usually given in service trainings and on the job trainings by the nursing staff. .After sufficient trainings, the nursing attendants are already liable for their own actions. If a nurse delegates her functions to the nursing attendant and the latter commits mistake, the former should be held liable for the mistake. 15. Guidelines for Reducing Liability. While following these guidelines is not a guarantee of nurses not being involved in litigation but at least it should reduce their chances of being involved in malpractice lawsuit.

a. Be knowledgeable in your clinical specialty; b. Demonstrate concern for clients in day to day care for them;

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c. Learn how to correct medical record entry errors;

d. Question any physician/ doctor's order, which is not understood or agreed with

e. Document appropriately and accurately;

f. Understand the equipment used at the health care facility;

g. Be familiar "with and follow the health care facilities' written policies and procedures.

h. Collaborate and communicate with other members of the health care team.

16. Giving and Charting Medications

a. Whoever prepares the medications should give them and sign the chart as having given them.

b. Check all medications and treatment cards against medication

sheet to be sure all cards are there. The

c. Chart immediately after giving narcotics given as "STAT". pre-op medications and

d. For PRN laxatives - check first if client really needs it before giving

e. Chart on Remarks column site where injection is given, i.e, LUOQ gluteus muscles, and right deltoid muscles.

f. Be specific in recording IV & IV push which are given by the doctor or the nurse in the presence of the doctor assuming responsibility for it.

g. Skin testing is done to clients who will be given antibiotics and Vit B preparations. The skin test result is read or interpreted by ROD and first dose of antibiotic IV push is given by the doctor or the nurse in the presence of the doctor assuming responsibility for it.

h. Medicine cards with cut at the center are used for injectable medicines, while slanted cut are used for treatments. Medicine cards without any cut arc used for oral medications.

17. Rules for Administering Drugs Safely.

a. Administer the right drug. b. Administer the right drug to the right client

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c. Administer the right dose.

d. Administer the drug by its right route.

e. Administer the right drug at the right time.

f. Document each drug upon administration.

g. Teach your client about the drugs he/she is receiving.

h. Take a complete client drug history. (There is a risk of adverse drug reactions when a number of drugs are taken or when client is taking alcoholic drinks)

i. Find out if the client has any drug allergies.

j. Be aware of potential drug-drug or drug-food interactions to protect your clients and your license. Follow these guidelines for avoiding medication errors. 18. Nurses Responsibilities In Drug Administration

a. Basic principles of drug administration are to be observed carefully at all times. A standard time of administering medication is followed except for those orders with specified hour or time of administration. Standard colors are used in conjunction with this standard time of drug administration. The color code would indicate a certain number of hours or frequencies within the 24 hour period.

b. Standard color medication card or treatment card should always

accompany any medication or treatment being administered to make sure that the right dose and kind of medication or treatment is given to the right client.

c. All medicine/treatment cards are signed and dated by the nurse who transcribed the medical orders on the cards.

d. All medications are started as soon as possible but the succeeding doses are administered and accordingly adjusted to the standard time as practiced.

e. Standing order medications and treatments cancelled/ discontinued under the following circumstances: are

1) When client goes to surgery or for laboratory examinations,

2) When the client manifest signs of allergic reactions to the

drug,

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3) According to the policy for narcotics and antibiotics approved by the Medical Staff.

f. Observe the color index for medicine cards: (Figure 8-1)

g. Follow the standard hours for administering drugs: (Figure 8-2)

h. Follow the shape of the Medicine cards: (Figure 8-3)

i. Self administration of medications by client is not permitted except for emergency drugs with special orders from the physician.

j. Medication errors and drug reactions are immediately reported to the client's physician and an entry thereof made in the client's clinical record as well as an incident report;

k. Client's medications must be' properly labeled;

l. Client's medications having an expiration date are removed from usage after such date and properly disposed of.

m. A narcotic record book is maintained. Narcotics and other controlled drugs are counted on each shift by one nurse coming on shift and one nurse going off shift.

n. Use only standards abbreviations. When in doubt, write out the word or phrase.

o. After administering the first dose, sign your full name and initials-in the appropriate space.

p. Record drugs immediately after administering them so another nurse doesn't inadvertently repeat the dose.

q. If a specific assessment parameter must be monitored during administration of a drug, document this requirement. For example, when Digoxin is administered, the client's pulse rate/cardiac rate needs to be monitored, so the client's pulse rate/cardiac rate should be documented.

r. Follow the Therapy important points in the administration of IV

1) All IV fluids are calibrated as ordered: cc/hr and gtts/min. Late or delayed IV fluids must be reinserted and adjusted accordingly.

2) Separate IV sheets are used for recording the main N

fluids from side drip or piggy back IV fluids received by a client.

3) When IV drugs are to be incorporated into the IV Solution:

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(a) Use newly opened disposable sterile syringe and needle.

(b) Write on a card (IV tag), with the following data:

name of client, name of IV + medication incorporated (if there is), date and time N fluid hooked.

(c) Attach card IV tag to the IV infusion bottle where it

could easily be read.

(d) IV tape placed on the site IOf IV insertion with the following data: date, time and site of insertion, type of needle used.

Table 8-1 COLORED INDEX FOR DRUG ADMINISTRATION

Color (Legend) Frequency White OD once a day Yellow BID Twice a day Pink TID Three times a day Green QID Four Times a day Blue q Every 2-3-4-6-8-12 hrs Red PRN when necessary Orange H.S at bed time

Table 8-2 STANDARD TIME FOR DRUG ADMINISTRATION

FREQUENCY TIME OD BID TID QID AC PC HS q 2 hrs q 3 hrs q 4 hrs q 6 hrs q 8 hrs q 12 hrs

- 0800H - 0800H – 2000H - 0800H – 1300H – 1800H - 0800H – 1200H – 1600H – 2000H - 30 minutes before meals - 1 hour after meals - 2000H - 0800H – 1000H – 1200H – 14000H etc - 0900H – 12000H – 1500H – 1800H – 2100H etc - 0800H – 1200H – 1600H – 2000H – 2400H – 0400H - 0600H – 1200H – 1800H – 2400H - 0800H – 1600H – 2400H - 0800H – 2000H

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Table 8-3

DIFFIRENT SHAPES OF MEDICINE CARDS

Table 8-4 Format/ Guide in filling up medicine card

19. Medication errors takes the following forms:

a. Omission error. The failure administers an ordered dose. However, if the client refuses to take the medication, no error has occurred. Likewise, if the dost" is not administered because of recognized contraindications, no error occurred.

ORAL MEDICATION

TREATMENT

PARENTAL

Bed No: ________ Date Started Surname: First Name MI Medicine: Frequency Time Signature Printed Name of Med Nurse

Bed No: 3 Date Started 26 June 2000 Porlante, Marea G Paracetamol 1 tab TID 0800H – 1300H -1800H Time

edna c ching EDNA E CHING RN

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b. Unauthorized drug error. Administration to the client of a

medication dose not authorized the client. This includes a dose given to the wrong client, duplicate doses, and administrator of an unordered drug and a dose given outside a stated set of 'C. meal parameters (e.g. Medication order to administer only if the clients blood pressure falls below a predetermined level).

c. Wrong dose error any dose that is the wrong member of preformed units (e.g. tablets) or any dose below or above the ordered dose by a predetermined amount (e.g. 20 percent). In the case of ointments, topical solutions and splays., an error occurs only if the medication order expresses the dosage quantitavely (e.g. 1 inch of ointment or two (2) second Sprays)

d. Wrong route error. Administration of a drug by a route other than

t11at ordered by the physician. Also included are doses given via the correct route but the wrong site (e.g. right eye instead of left eye.)

e. Wrong rate error. Administration of a drug at the wrong rate,

other than the connect rate being given based on the physician's order or as established by hospital policy.

f. Wrong dosage form error Administration of a drug by the correct

route but in a different dosage form other than that specified or implied by the physician. (e.g. use of an ophthalmic ointment when a solution was ordered.) Purposeful alteration or substitution of an oral dosage form to facilitate administration is generally not an error. (e.g. crushing of a tablet; substituting a liquid for a tablet).

g. Wrong time error. Administration of a dose of drug at a time

greater than X hours from the scheduled administration time, X being as set by the administration/hospital policy.

h. Wrong preparation of a dost", incorrect preparation of the

medication dose, (e.g. incorrect dilution or reconstitution, not shaking a suspension, using an expired drug and mixing drugs that are physically and chemically incompatible:

i. Incorrect administration techniques situations when the drug is

given via the correct route, site and so forth but technique is wrong. (e.g. not using the Z-track injection when indicated for a drug, incorrect -installation of an ophthalmic ointment and incorrect use of an administration device.)

20. Handling Procedures in Medication Errors. Recognizing the need to correct any deficiency in the administration of medications, the Nursing Administrator,/Supervisor win counsel the nurse who has committed an error in order to develop sensitiveness and awareness to the events leading to the error,

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a. Disciplinary action as H. result of medication error will be handled by and at the discre1ion of her immediate supervisor. The judgment resulting in disciplinary action vv-ill be based on the:

1) Severity of the medication error 2) Involved a period of time.

3) The number of Indication errors in a period of time.

4) If irreversible (Image to the client is present or has the

possibility of such damage, the Chief Nurse reserves the right to institute recommend immediate suspension from work or termination for medication error.

5) If the nurse demonstrated negligence or irresponsibility in her reaction to the error.

Section 8-4 Right and Responsibilities

21. The Nurse's Responsibility for the Client's Safety. Nurses are responsible for providing safe care both physically and psychologically to all clients under their care. Likewise, care givers within the clients' care unit should promote an environment conducive to early recovery. 22. Rights and Responsibilities of Clients. The basic rights of human beings for independence of expression, decision, and action and concern for personal dignity and human relationships-are always of great importance. During sickness-s. The presence or absence of these rights becomes a vital, deciding factor in the client's survival and recovery. Thus, it is the hospital's prime responsibility to assure that these rights are preserved for their clients. In the provision of care, the hospitals have the right to expect behavior on the part of clients and their relatives and friends which considering the nature of their illness, is remarkable and responsible. 23. Clients Rights

a. Access to Care. Individual shall be accorded impartial access to treatment or accommodations that are available or medically indicated, regardless of race, creed, sex, national origin or sources of payment for care.

b. Respect and Dignity. The client has the right to a considerate,

respectful care at all times and under all circumstances 1Mth recognition of his personal dignity.

c. Privacy and Confidentiality. The client has the right within the law, to personal and informational privacy, as manifested by the following rights:

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1) To refuse to talk with or see anyone not officially

connected with the hospital including visitors or persons officially connected with the hospital but not directly involved in his care,

2) To wear appropriate personal clothing and religious or

other symbolic items as long as they do not interfere with diagnostic procedures or treatment.

3) To be interviewed and examined in surroundings designed to assure reasonable visual and auditory privacy. This includes the right to have a person of one's own sex present during certain parts of a physical examination, treatment, or procedure performed by a health professional of the opposite sex and the right not to remain disco bed any longer than is required for accomplishing the medical purposed for which the client was asked to disrobe.

4) To respect that any discussion or consultation involving his care will be conducted discreetly and that individuals not directly involved in his care wilt not be present without his permission.

5) To have his medical record read only by individuals directly involved in his treatment or in the monitoring of its quality and by other individuals only by individual written authorization or that of his legally authorized representative

6) To respect all communica1ions and other records pertaining to his care, including the Sucre of payment for treatment to be treated as confidential.

7) To request a trampers to another room if another client or a visitor in the room is unreasonab1y disturbing him.

8) To be placed in protective necessary for personal safety.privacy when considered

d. Personal Safety. The client has the right to reasonable safety insofar as the hospital practices and environment are concerned.

e. Identity. The client has the right to know the identity and

professional status of individuals providing service to him and to know which physician or other practitioner is primarily responsible for his care. This includes the client's rights to know of the existence of any professional relationship to any other health care or educational institutions involved in his care. Participation by clients in clinical training programs or in the gathering of data for research purposes should be voluntary.

f. Information. The client has the right to obtain, from the

practitioner responsible for coordinating his care, complete and current information concerning his diagnosis (to the degree known) treatment and any

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known prognosis. This information should be communicated in terms the client can reasonably be expected to understand. When it is not medically advisable to give such information to the client the information should be made available to legally authorized individual.

g. Communication. The client has the right of access to people

outside the hospital by means of visitors and by verbal and written communications

When the client does not speak or understand the predominant language of the community, he should have access to an interpreter. This is particularly true where language barrier is a continuing problem.

h. Consent.

The client has the right to reasonable informed participation in decisions involving his health care. To the degree possible, this should be based on a clear, concise explanation of his condition and of all proposed technical procedures, including the possibilities of any risk of mortality or serious side effects, problems related to recuperation, and probability of success. The client should not be subjected to any procedure without his voluntary, competent, and understanding consent or that of his legally authorized representative. Where medically significant alternatives for care or treatment exist, the client shall be so informed.

The client has the right to know who is responsible for

authorizing and performing the procedures or treatment. The client shall be informed if the health care facility proposes to engage in or perform human experimentation or other research/educational projects affecting his care or treatment, and the client has the right to refuse to participate in any such activity.

i. Consultation. The client, at his own request and expense, has

the right to consult with a specialist.

j. Refusal of Treatment. The client may refuse treatment to the extent permitted by law. When refusal of treatment by the client or his legally authorized representative prevents the provision of appropriate care in accordance with professional standards, the relationship with the patient may be terminated upon reasonable notice.

k. Transfer and Continuity of Care. A client may not be transferred to another facility unless he has received a complete explanation of the need for the transfer and of the alternatives to such a transfer and unless the transfer is acceptable to the other facility. The client has the right to be informed by the practitioner responsible for his care, or his delegate, of any continuing health care requirements following discharge from the hospital.

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l. Health Care Facilities' Charges for Authorized Civilians. Regardless of the source of payment for his care, the civilian patient has the right to request and receive an itemized and detailed explanation of his total bill for services rendered in the health care facility. While the Registrar of the health care facility is responsible for assigning values to the goods and services provided to the client, the Nursing Service is responsible for submitting the itemized list of particulars, which will cover some if not all of the following:

1) Name of civilian client and inclusive dates admitted and

discharge 2) Medications used and date/time/ dosages

3) Nursing supplies used and date/time of issue

4) Special feedings (if any)

5) Laboratory' procedures done

m. Health Care Facilities' Rules and Regulations. The client should

be informed of the hospital rules and regulations applicable to his conduct as a client. Clients are entitled to information about the hospital's mechanism for the initiation, review, and resolution of client's complaints. 24. Clients’ Responsibilities

a. Provision of Information. A client has the responsibility to provide, to the best of his knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his health. He has the responsibility to report unexpected changes in his condition to the responsible practitioner. A client is responsible for repor1mg whether he clearly comprehends a contemplated course of action and what is expected of him.

b. Compliance with Instructions. A client is responsible for following

the treatment plan recommended by the practitioner primarily responsible for his care. This includes following the instructions of nurses and allied health care workers as they carry out the coordinated plan of care and implement the responsible practitioner's orders, and as they enforce the applicable rules and regulations. The client is responsible for keeping appointments and, when he is unable to do so for any reason, for notifying the responsible practitioner of the health care facility.

c. Refusal of Treatment. The client is responsible for his actions if he refuses treatment or does not follow the practitioner's instructions.

d. Hospital Rules and Regulations. The client is responsible for following hospital rules and regulations affecting client care and conduct.

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e. Respect and Consideration. The client is responsible for being considerate of the rights of other clients and hospital personnel and for assisting in the control of noise, smoking and the number of visitors. The client is responsible for being respectful of the property of other persons and of the hospital.

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CHAPTER 9 ADMINISTRATIVE TOOLS

Section 9-1 Records/Reports

1. General. Records are hospital administrative tools used in collecting data directed towards the attainment of the objective of its sections and department. They are the sources of cumulative and relevant information that may be used as basis for client management and the effective programming of activities for research and decision-making. Reports are prepared accounts of important activities of the Nursing Service within a particular period. They must always be dated. 2. Importance of Records and Reports

a. It is a legal document which provides evidence of the care given to a client in a particular health agency.

b. It is a communication linkage or system by which members of

the health team exchange views and information about the client, his therapy and his response to therapy.

c. It is used extensively for research and statistical purposes.

d. Utilized for audit purposes to determine the quality and quantity of care a client has received.

e. Health care professionals reading a client's chart can learn a great deal about the clinical manifestations of a particular health problem, effective treatment modalities and factors affecting client goal achievement.

f. Historic document - because dates of entries on records are specified, the record has value as a historic document. Years later, information may become pertinent concerning a client's past health care.

3. Nursing Service Office Records. For effective administration of the Nursing Service, the Chief Nursing Service should provide complete and up- to-date records. The following should be available in the Office of the Chief Nursing Service:

a. Personal Record (Form 201). This includes a copy of the personal data, appointments, references, achievements, staff and professional activities and confidential information of both military and civilian employees of the Nursing Service.

b. Master Staffing Pattern. This is a daily assignment of the nursing

personnel which will help the Chief Nursing Service visualize the coverage of

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all nursing units, serving as a guide and support for proposing additional positions in the Nursing Service. It contains the actual number of nursing staff on sick leave, on-the-job training and on study leave and others.

c. The Daily Census of Clients. This includes a detailed list of actual clients in the different wards/units and the total census for 24 hours.

d. Daily Time Record or Bundy. Card This indicate the time each personnel reported to and from duty.

e. Nursing and Hospital Policies. All directives affecting the Nursing Service are compiled in a loose-leaf manual, which is available for reference. These may refer to policies on admissions, discharges, transfers, fire regulations, time and work schedules, charging of clients, etc. Directives are dated and signed by the sender.

f. Manual of Procedures. A set of standard operating procedures such as those for:

1) Carrying out verbal/ telephone orders for medications 2) Errors in medication

3) Omission of treatment

4) Preventive measures, such as, use of side rails and

restraints

5) Assembling of the client's clinical charts

6) The transfer of doctor's orders to the nurses' record

7) Preparation of medicine cards, established medication, time and other client related procedures.

8) Minutes of the Nursing Service Meetings

9) Nursing Affiliation Record (for training and teaching hospitals)

(a) The school/college folder contains approved affiliation contract with the list of student’s including the date and time for affiliation and the clinical instructors.

(b) Records of payments provide the number of

students; date and length of affiliation, and payments each with corresponding receipt number and date such were paid.

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(c) Quarterly Report of Affiliation.

(d) Performance Evaluation Record of Affiliation.

10) Records of Staff Development Programs conducted

11) Quality Assurance Program Record

12) Record of Nursing Researches conducted

13) Record of Turnover. This includes the following information:

(a) The dates of appointment and resignation of military and civilian employees of the Nursing Service.

(b) Accumulated leave credits and the date the

resignation letter was filed and the result of the exit interview.

14) Records of Activities of the various departments 4. Nursing Office Reports

a. Monthly Reports. Monthly Reports are prepared by the Chief Nursing Service and NIC to be submitted to the Office of the Army Chief Nurse for compilation. Date of submission is according to SOP.

The monthly reports of all PA Nursing Service will be

submitted to the OTCN on date specified according to SOP.

b. Quarterly j Semi Annual Reports. Quarterly I Semi annual reports are prepared by Chief Nursing Service and NIC and submitted to the Office of the Army Chief Nurse on dates of submission according to SOP.

5. Nursing Unit Reports

a. Time slip

1) Time slip reports are prepared by head nurses/senior staff nurses on duty every shift and submitted to the supervisor on duty.

2) The purpose of the time slip is to determine if there is a

need to augment the nursing staff of a ward or if there is more than what is actually needed.

3) The time slip includes the ward census, number of clients in the ward and clients out on pass; status of military and civilian employees of the Nursing Service for the shift (duty, off duty, leave, absent and others)

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b. 24 Hours Report. Twenty four (24) hours report is accomplished by the night shift duty nurse and is submitted to the supervisor on duty for consolidation and compilation. It includes the following:

1) Number of clients of each ward 2) Number of admissions/discharges/evacuations/trans-in,

Trans-out, SIL and deaths.

3) Category of clients according to status (Officers, enlisted personnel, dependents, civilians and others).

4) Category of clients according to their needs 6. Client's Chart. Client's chart is a systematic compilation of all records and reports of individual client admitted in the hospital which shows the changes/development in his condition. 7. Contents of a Client's Chart

a. Standing Order sheet b. Cover sheet

c. Admission notes

d. Problem List e. Referral/Consultation sheet

f. Laboratory results

g. Doctor's Order sheet

h. Medication sheet

i. TPR sheet

j. Nursing AsseS8ment Guide/Systems Review k. Nurses' notes 1.

Miscellaneous

1) Consent 2) Pre-op checklist

3) Anesthesia record

4) OR Technique

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The arrangement/ sequence of the contents during hospitalization varies according to the ward officer's prerogative. However, upon discharged, the chart to be submitted will be arranged according to the health care facility's policy. A clinical record for each client admitted with all entries kept current, dated and signed. The chart contains all necessary forms required for treating or caring for a client. Daily information concerning the client is charted by the nurse carrying out the order, e.g. treatments, medications, observations and others.

8. Nurses' Reports. Nurses' reports are legal documents, which are important elements of the client's chart, thus the record should be truly reflective of what transpired during the client's hospitalization. The objectives of Nurse's Reports are:

a. To keep a current, concise and accurate record of the client's hospitalization.

b. To provide the health team with a guide for future care in the

rehabilitation of a particularly.

Section 9-2 Forms

9. General. Forms are documents with blanks for the insertion of requested/required/needed information. The following are the standard forms used in all PA Nursing Service 10. Medication Sheet. A form wherein all the medications administered to a client are charted or recorded except "STAT" medications and injections. (Annex D) The nurse writes her full printed name and signature at the lowest space. Proper notation of the date and changes in medications and treatments like: DC - discontinued Shifted to IV or p.o Out of stock; "changed Dose increased and decreased Frequency changed Hold "Dose completed" which shall appear after specific number of doses. Encircle time when medicines or treatments are not given with appropriate remarks indicated in nurses' notes. 11. TPR Sheet. A form where clients' temperature, pulse rate and respiratory rate, blood pressure taken on certain hours during the whole twenty four (24) hours are recorded and illustrated in the graph. It also contains data such as number of voiding and bowel movement and the patient's weight. (Annex D 1)

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a. TPR Sheet shall include:

1) properly dated column 2) Properly indicated hospital days A 1st hospital day is

counted 24 hours after admission

3) Date, type of surgery indicated above a diamond ( ) written in red and numbered succeeding post-op days.

4) Properly recorded TPR

(a) Temperature and respiratory rate are all recorded in blue or black ink

(b) Identify oral temperature with a dot (.)

(c) Identify axillary’s temperature with "a.x" written

above the dot (a. x)

(d) Identify the rectal with an encircled dot ( . )

(e) Pulse rate or cardiac rate recorded in red ink.

(1) Broken lines indicating changes in temperature after nursing measures.

(2) Number of bladder and bowel eliminations

recorded every shift: "IC" - indwelling catheter "CC" - Condom catheter " E" - Enema

b. Routine in Taking Vital Signs (Temp. PR, RR, BP)

1) A febrile clients - once during each shift unless specified by the attending physician.

2) Febrile clients - every four (4) hours until the temperature

is back to normal unless specified by the attending physician. 3) Post operative clients - every four (4) hours regularly for

the first 48-72 hours unless specified by the attending physician.

4) Duration of time the following route of temperature is taken.

(a) Oral temperature- taken for 7 minutes (b) Auxiliary temperature - taken for 5 minutes iii.

Rectal temperature - taken for 3 minutes

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5) Keep BP records as long as they are ordered. It may be discontinued only by the doctor. When pulse and respiration are to be checked, count both for one whole minute. Variations are diagnostic according to the patient's condition or disease entity.

12. Intake and Output Sheet. A form wherein intake and output are accurately recorded every shift or as ordered (Annex D2) It shall include the following:

a. Accurately recorded I & 0 every shift

1) Intake includes oral and parenteral IV fluids like blood, plasma. mannitol, and others.

2) Output includes urine, vomitous, NGT drainage, wound

drainage and others

b. Twenty four (24) hours intake and output shall be summed up by the night duty nurse. If there is a big discrepancy between the intake and output, the nurse should refer to the ROD immediately. Clients on hourly urine/output measurement should be referred if the output is less than 30 cc / hour.

c. Keep 1&0 as long as ordered. Nurses failing to complete this

record shall be called back to complete them. It is from this record that the doctor computes the fluid requirement of the client.

13. Doctor's Order Sheet. This sheet contains the written, copied, verbal or telephone orders of the attending physician in charge of the medical case of a particular client. Nursing care is planned according to these orders. (Annex D3)

a. Nurses' responsibility is transcribing and carrying out doctors' orders.

b. The nurse takes down verbal telephone orders as follows:

1) Writes the date, time, when order was given. 2) Reads back the orders to the physician concerned as

accuracy and clarity.

3) Have the orders signed by the doctor concerned as soon as possible.

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4) Signs her name as the nurse who received the orders. Verbal telephone order is tolerated only on emergency and not to be considered as routine.

c. All orders must be carefully checked before transcribing to the Kardex, medications sheet, medicine cards or other departmental request forms.

d. Bracket the written orders as the nurse checks the orders and

the nurse signs her name as the one who carried out the orders, the date and time the orders were carried out.

e. All transcribed orders are properly dated, timed and initiated by the nurse on the left hand corner of the order and after each line of doctors order initialed using red ink.

f. Verbal orders, telephone orders, copied orders properly initialed as V.o., t.o., and countersigned by the receiving nurse ex., T. 0.., Col Guerrcro/Magabo.

1) In case of direct admission, the order sheet from the

doctor shall also be countersigned by the receiving nurse. 2) Verbal orders, telephone orders, copied orders are

countersigned by the physician giving the order within 24 hours.

3) For a clear collection of mistakes, enclose the word or words in a parenthesis: Write "ERROR" over it in such a way that the original mistakes could be identified.

g. All medicine cards and treatment cards that were carried out

and when discontinued must be immediately discarded. 14. Nurses Progress Notes Sheet. This form is used in charting or recording the significant observations and evaluations of a client's condition during each tour of duty. (Annex D4) It shall include the following.

a. All admission information entered accurately in the Nurses' Notes

b. Immediate client's condition and needs

c. Recording of pertinent observations and communications

d. Properly recorded and accurately timed stat or single dose

medications and treatments using red ink.

e. Accurate recording of nursing interventions and evaluations of the effectiveness of care

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f. Any further information that communicates necessary nursing

activities to the next shift. "Needs attended", "Nothing unusual notes'" "Slept fairly" "ambulatory" and the likes should never be written as observations.

g. Signature on top of printed name at the end of all recordings per shift. Do not leave blank lines in between Nurses' notes or between shifts.

h. Discharge names shall use the Acronym "METHOD" M - Medication- refers to the medicines that the client is taking.

• The nurse must find out if the client is aware of the

indications of these medicines and their side effects, if any. Also, does the client have any medication allergies?

E - Economic status of the client - the home environment

considered and the possible problems he may have regarding follow-up Cfu1ic visits.

T. - Treatme'1.t to be done at home - the client receives

instructions on the prescribed activities the nurse must have the answer to two (2) questions:

To what extent can the client carry on the prescribed

activity? Who: 8 available to help carry out the necessary treatment?

H - Health Teaching to be given to the patent includes general instructions on personal hygiene, activity, rest, sleep" exercise and elimination.

O - Out - patient follow-up of client D - Diet prescribed for the client (foods allowed and not allowed) S - Spiritual

The head nurse or charge nurse goes over the charting of all clients

before the shift ends in order to supplement whatever is lacking or to make corrections.

Corrections in nurse's notes are made by drawing a straight line through and across the word/words and the connection is written above or following the line. The signature of the one who corrected it should appear clearly.

15. Intravenous Flow sheet/Intravenous Fluid Sheet. This form is used to record all intravenous fluids infused. (Annex DS) It shall include the following:

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a. Name of solution and amount to be infused and the rate of flow b. Date and time the solution was inserted and infused

c. Medicine added if any

d. Date and time the solution was consumed/ discontinued or out

of vein

e. The amount of solution infused

f. Remarks/ comments Ex. Out of vein - client refused reinsertion

If the nurse received the fluid at 300 cc levels at the beginning of the

shift and the 300 cc was consumed before the end of the shift and another 500 cc per bottle is followed up, indicate as such to include how much fluid was consumed prior to the end of the shift. 16. Standing Order Sheet. (Annex D6) The form includes the following

a. Medications/treatment, route dosage frequency ordered b. Date/Time ordered and discontinued/changed

c. Signature of nurse who filled up Standing Order Sheet

d. If revised then state as such

17. Nursing Problem List Form. (Annex D7) It includes the following

a. Date of Onset - the approximate date the client/ significant others had noticed/felt the complaint/s

b. Date identified - the date the problem was identified by the nurse

c. Problem No. - The number assigned to one particular problem.

18. Vital Signs Monitoring Sheet. Forms used for critically ill/post-op clients where vital signs need to be monitored regularly are recorded. (Annex D8). It should include:

a. Properly dated column b. Properly recorded BP, Temp, Pulse Rate, CVP, Level of

Consciousness 19. Kardex. The PA Nursing Service uses nursing Kardex as a system of organizing care plans. A nursing Kardex is a me that contains the nursing

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care plans. Each plan is recorded on an oversized index card or large folded sheet of paper. The form of the written care plan may vary from institution to institution, but it should be an l1seful tool for communicating care plans of clients among health care workers. Most Kardex will include space of nursing diagnoses, goals, nursing orders and evaluation in an abbreviated form. (Annex D9)

The written care plan should be used to communicate goals that cover several shifts or more and require the coordinated efforts of several nurses over a period of time.

20. Pointers in writing a nursing care plan on a Kardex:

a. Abbreviate whenever possible, using standardized medical or English symbols;

b. Choose key words to communicate ideas. Do not write whole

sentences;

c. Refer people to procedure books rather than trying to include all the steps for a procedure in a written plan.

d. Category headings should include nursing diagnosis, goals, nursing actions al1d evaluation;

e. The nursing diagnoses with the related goals and nursing actions should appear next to each other;

f. Include a date for evaluation of each goal;

g. All long term goals should be written. Nursing actions directly related to long term goals should be written;

h. Short term goals that can not be met within an 8- hour shift should be written in order that other nurses can continue the plan of care.

i. Long term goals being met by a series of short term goals have both the long term goals and the progressive short term goals on the Kardex. The accompanying actions for short term goals are included;

j. When goals are evaluated they should be signed and dated by the responsible nurse;

k. All nursing interventions (actions, orders) should be signed by the responsible nurse; The Kardex is a means of keeping standing medical orders written and the nursing care plan based from these orders for a client as a ready source of reference for the nursing staff of the unit. It is utilized in the giving of reports OT endorsement by all three shifts. The information written in the Kardex should be sufficient and clear enough to give the

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supervisors and other members of the team of what happened to the client during the previous shift or during the time they were off or absent.

Section 9-3 Documentation

21. Charting. All client record systems provide a section for writing descriptive nursing progress notes about the client's status and progress. There are several methods of writing nursing progress notes however, the most common methods are (1) chronological/traditional narrative, (2) SOAP format, (3) Focus charting, and (4) charting by exception. The PA Nursing Service has adopted the Traditional narrative charting as the method used in documenting the client's status and progress. 22. Traditional Narrative Carting. (Annex E) The traditional narrative charting is a chronological account of the client's status, the nursing interventions performed and the client's responses. In the traditional narrative system, data are recorded as progress notes, with flow sheets supplementing the narrative notes. When and what to document and how to organize the data are the key elements of effective narrative charting in the progress notes. Specific and descriptive narrative such as: a) a change m the client's condition (progression or regression) example. Mrs S.A. can ambulate with a walker for three (3) minutes before feeling tired. b) a lack of improvement in the: client's condition. Example. Mrs S.A. verbalizes that her abdominal pain was relieved one (1) hour after receiving medication. She is smiling and able to turn in bed without difficulty. c) a client's or family member's response to teaching. Example. Mrs S.A. was able to demonstrate crutch walking using the proper technique.

A charting format called AIR may help the nurses to organize and

simplify their narrative charting. AIR is an acronym for: Assessment -Summarize the physical assessment findings. Begin by

specifying each issue that you address, such as nursing diagnosis, admission note, and discharge planning. Rather than simply describing the patient's current condition, document trends and record your impression of the problem.

Intervention - Summarize your actions and those of other care givers in

response to the assessment data. The summary may include a condensed nursing plan of care or plans for additional patient monitoring.

Response - Summarize the outcome or the patient's response to the

nursing interventions. Because a response may not be evident for hours or even days, this documentation may not immediately follow the entries. In fact, it may be recorded by another nurse, which is why titling each of your assessments and interventions is so important.

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OCG

OVC

OCS

AIG ACESPA ACPA

AIDE ASM

SAGS AOC

G6 G7 G8 G10 G11 G1 G2 G3 G4 G5

ACCS ACA ACE ACI AJAG ACN AC, SURG

ADS AAG APM ACOCS ACQM MIPO

SPECIAL AND TECHNICAL STAFF

COORDINATING STAFF

PERSONAL STAFF

ANNEX A

HEADQUARTERS PHILIPPINE ARMY

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ACN

DEP ACN

NS, CSSH

NS, CESH

NS, FMASH

NS, CPSH

NS, CCSH

NS, KCSSH

NS, CLSH

NS, CMDCSH

NS, FBHG

MIL WARD

CESH ANNEX

DTU MED

52ND EBDE MED INF

54TH EBDE MED INF

51ST EBDE MED INF

2ID MED INF

LABDE MED INF

SOCOM

SFR MED INF

FSRR MED INF

ORGANIZATION OF PA NURSING SERVICES

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ACN

Dep, ACN

C, ADMIN & PERS BR C, PLANS & TRAINING BR

NCOIC/C, CLERK

FINANCE SGT SUPPLY SGT FILLING CLERK/ GEN MSGE CTR

CLERK

DRIVER

ENCODER/TYPIST

INST’L WORKER

ORGANIZATION OF THE OFFICE OF THE ARMY CHIEF NURSE

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PA HOSPITAL

MED SVC ADMIC SVC NURSING SVC

ORGANIZATIONAL RELATIONSHIP OF THE NURSING SERVICE WITH OTHER SERVICES IN PA HOSPITALS (Tri-Service)

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NURSING SVCS

NURSING CARE BR

NSG RESEARCH & QTY ASSURANCE

NSG ADMIN BR

NSG EDUC & TRNG BR

CLINICAL SEC AMBULATORY SEC

SUPPORT SEC

SURGICAL WD

MED WD

OB-GYNE WD

PEDIA WD

FAMILY PLANNING

CLINIC

WELL/SICK BABY

CLINIC

CONSULTN TREATMENT

RM

EMERGENCY RM

OPERATING RM

DELIVERY RM

CSR

LINEN RM

LAUNDRY RM

NURSING SERVICE OF A

GENERAL/ TERTIARY HOSPITAL

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NURSING SVCS

NURSING CARE BR

NSG RESEARCH & QTY ASSURANCE

NSG ADMIN BR

NSG EDUC & TRNG BR

CLINICAL SEC AMBULATORY SEC

SUPPORT SEC

SURGICAL WD

MED WD

OB-GYNE WD

PEDIA WD

FAMILY PLANNING

CLINIC

WELL/SICK BABY

CLINIC

CONSULTN TREATMENT

RM

EMERGENCY RM

OPERATING RM

DELIVERY RM

CSR

LINEN RM

LAUNDRY RM

NURSING SERVICE OF A

STATION/ SERCONDARY HOSPITAL

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NURSING SERVICE OF A MEDICAL INFIRMARY

MOBILE

CONSULTATION/ TREATMENT

MEDICAL

SURGICAL

OBSERVATION RM

MILITARY

DEPENDENTS

FIXED OR STATION

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ANNEX B

UNIFORMS

GOA UNIFORM FOR MALE OFFICER

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GOA UNIFORM FOR FEMALE NC OFFICER

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GOA (PANTS) UNIFORM FOR FEMALE NC OFFICER

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GRAY BLOUSE UNIFORM FOR MALE NC OFFICER

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GRAY BLOUSE UNIFORM FOR FEMALE NC OFFICER

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HOSPITAL UNIFORM FOR MALE NC OFFIICER

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HOSPITAL UNIFORM FOR FEMALE NC NC OFFICER

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HOSPITAL UNIFORM FOR PREGNANT NC OFFICER

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HOSPITAL UNIFORM FOR FEMALE CIVILIAN NURSE

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HOSPITAL UNIFORM FOR FEMALE CIVILIAN NURSE (PANTS)

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HOSPITAL UNIFORM FOR MALE CIVILIAN NURSE

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HOSPITAL UNIFORM FOR MIDWIFE AND NURSING ATTENDANT

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HOSPITAL UNIFORM FOR MALE INSTITUTIONAL WORKER

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HOSPITAL UNIFORM FOR FEMALE INSTITUTIONAL WORKER

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ANNEX C

UTILIZATION OF NURSE CORPS IN ECHELONS OF MEDICAL EVACUATION

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R E S T R I C T E D C-2

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R E S T R I C T E D D-1

ANNEX D

PA NURSING SERVICE MEDICATION SHEET

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PA NURSING SERVICE

TPR SHEET

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PA NURSING SERVICE

FLUID INTAKE OUTPUT SHEET

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DATE/TIME DOCTOR’S ORDERS SHEET

LAST NAME, FIRST NAME, MIDDLE NAME Rank AFPSN DIAGNOSIS Ward# Bed# Sex Age Date Adm Reg

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PA NURSING SERVICE

NURSES’ PROGRESS NOTES

Date/Time/ Shift

Progress Notes Date/Time/ Shift

Progress Notes

DIAGNOSIS LAST NAME, FIRST NAME ,MIDDLE NAME RANK AFPSN WARD# Bed# Sex Age Date Adm Reg#

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PA NURSING SERVICE

INTRAVENOUS FLUID SHEET DATE/TIME SOLOTION/AMOUNT

MEDS ADDED RATE AMOUNT

INFUSEDDATE/TIME FINISHED

AMOUNT ENDORSED

SIGN

PATIENT FIRST NAME LAST NAME MI REG NO. WARD/B ED NO.

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PA NURSING SERVICE STANDING ORDER SHEET

DATE Ordered Date Disc Medication and

Treatment Remarks

Last Name, First Name, Middle Name Rank AFPSN DIAGNOSIS Ward # Sex Bed# Age Date Adm Reg

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PA NURSING SERVICE NURSING PROBLEM LIST

PROBLEM Nr DATE NOTED NURSING

PROBLEM DATE RESOLVED

Rank Last Name MI First Name Hosp Wd Reg Nr

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PA NURSING SERVICE VITAL SIGN MONITORING SHEET

DATE/ TIME

BP PR CR RR T CVP LEVEL OF CONSCIOUSNESS

REMARKS SIGN

Last name First Name MI Hosp: Reg No: Ward No Diagnosis:

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PA NURSING SERVICE

NURSING CARE PLAN (I)

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PA NURSING SERVICE

NURSING SYSTEM REVIEW CHART

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PA NURSING SERVICE NURSING ADMISSION HISTORT AND ASSESMENT

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PART II

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R E S T R I C T E D E-1

ANNEX E

PA NURSING SERVICE NURSES’ PROGRESS NOTES

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R E S T R I C T E D E-2

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R E S T R I C T E D F-1

ANNEX F TITLE: AFP OFFICER APPRAISAL SYSTEM Authority: Circular #4 dtd 05 May 2003

1. PURPOSE: This Circular prescribes the policies and procedures in evaluating and .measuring the performance effectiveness and value of an officer to the service including the different report formats to be used for the said purpose.

2. DEFINITION OF TERMS: For the purpose of this Circular, the following terms shall be construed to mean:

a. Officer Appraisal System - This refers to an organized or established scheme or method of evaluating or measuring the performance, effectiveness and potential of an officer in the AFP.

b. Personal Attributes - This refers to the quality and

characteristics necessary and essential for an officer to perform his duties and responsibilities and to accomplish the assigned tasks.

c. Performance of Duty - This refers to the manner by which

an officer carries out and accomplishes the assigned tasks. d. Adjectival Rating - This refers to the actual description

and evaluation of the raterl indorser through his own words and handwriting of the performance effectiveness and the potential of an officer.

3. OBJECTIVES: a. To provide the AFP with information on an officer's

performance, effectiveness and value which, together with other available data, can be used as a guide in personnel actions.

b. To establish an effective scheme of rating individual

officer for every period of active service except while on leave prior to retirement, to be used as a tool for measuring the officer's value to the service as a basis for personnel action such as promotion, selection for training, assignment, reassignment, designation to key position, separation and to monitor the rated officer's performance.

4. GENERAL: Appraisal reports are of such far-reaching importance to the AFP and to the individual officer such that greatest care must be exercised in their preparation. Close attention to instructions contained in the form and to those in this Circular is mandatory to insure proper completion. All unit commanders must take appropriate steps to insure

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that all officers under them will be able to read and understand the contents of this Circular. All Commanders

a. Commanders will require officers under them to sign a Certificate (Incl E) which will be included in the MPF that they have read and understood the contents of the Circular, within one month from the effective date of publication or within one month after the appointment and/or call-to-active duty of an officer.

b. Disciplinary action will be taken by the appropriate

Commanders of the Major Services and the Deputy Chief of Staff (in case of officers assigned at GHQ and AFPWSSUs) against officers concerned who shall fail to accomplish the Appraisal Reports in accordance with this Circular. Report of disciplinary action taken will be transmitted to TAG, AFP.

c. All officers should be impartial, accurate, objective and All

officers should be impartial, accurate, objective and judicious in rendering Appraisal Reports and should realize the serious necessity of a realistic officer appraisal or evaluation in the AFP. Reporting officers should not let close personal association; animosities, prejudices and bias influence them. Given a rating higher than that merited by job performance is unfair not only to other officers but to the individual himself. Over-rating an officer may lead to assignment of duties for which he is not qualified. The ideal therefore, is to give ratings that are neither higher nor lower than merited.

The current efficiency status of organization shall not be the sole basis for judgment by a military superior as to the effectiveness of the commander thereof. The degree to which the effectiveness of an officer is reflected is the efficiency of his organization considering the time element and with the due allowance for factors beyond the control of the rated individual.

d. The Appraisal Report may be used by superiors as a tool

in counseling subordinates toward improved performance. Rates shall continuously correct deficiencies and stimulate improvement among subordinates.

e. Evaluation by the rater and endorser must be based on

facts and actual observation throughout the rating period. It should not be based only on few isolated incidents. In the absence of facts on which to base a rating, no rating should be made.

Rated officer will be evaluated vis -a- vis the

effectiveness with which he has discharged the responsibilities assigned to him, preferably based on a performance fist (i.e., duties and responsibilities) presented to him upon his assumption of duty- Designated raters shall not delegate the duty of performing the rating of an officer to other subordinate staff officer for any reason.

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5. ON WHOM RENDERED AND FORMS TO BE USED.

a. Appraisal Reports win be rendered on every officer of all grades except GeneraV Flag Officers in the active service.

b. Appraisal Reports for Officer-students at local military

schools will be made in AFP AGO Form 67-5 (Revised) (Incl A) in three (3) copies

c. quested by TAG, AFP from head of the institution in AFP

AGO Form 67-5 (revised) in three (3) copies. d. Appraisal Reports for Officer -students at local or foreign

schools will be requested by TAG, AFP from head of the institution in AFGP AGO Form 67-U (Revised) (Iod B) in three (3) copies.

e. Appraisal Reports for Officers on duty outside the AFP or

who are serving immediateiy under' non-AFP officiais win be requested by TAG, AFP from the head of the office, organization, or agency in AFP AGO Form 67-C (Revised) (Incl C) in three (3) copies.

On all officers, reports will be made in AFP AGO Form 67-M (Revised (Incl D) in three (3) copies..

6. BY WHOM RENDERED - Appraisal Report will be rendered by a rater and an endorser. The rater is the immediate superior, who has immediate supervision under the pertinent chain of command of staff structure of the rater. Officers on detail with military and civilian schools, local or foreign, or on detail with civilian agencies, win be rated by their respective Heads of Office based on AFP AGO Forms.

7. WHEN RENDERED:

a. Periodic - All officers will be rated at the end of June and December.

b. Relief of Rated Officer - It will be rendered upon relief of

the rated officer from his primary duty assignment in a military unit or in a civilian agency or when the rated officer is placed on temporary duty (TDY) or detached service (OS) in another unit for more than 30 days as specified by orders.

c. Relief of the Rater - Upon relief of the rater who has

served for more than thirty (30) days. d. Relief of the Endorser - Upon relief of the endorser who

has served for more than thirty (30) days. e. On special occasions as follows:

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1. On completion of MDT, duty as a student (local or foreign) or duty outside the AFP.

2. When, in the opinion of the rater, an individual is

so deficient in ability or performance of duty as to require reassignment, adverse personnel action, or disciplinary action.

3. When, in the opinion of the rater, the manner of

performance of duty is so outstanding as to justify submission of a special report.

4. When, in the opinion of the rater, the manner of

performance of duty is so outstanding as to justify submission of a special report.

8. FORM ACCOMPLISHMENT:

a. Preparation

(1) Entries on items 1 to 9, 12 & 13 and 16 to 20 of Form 67 -M (Revised) will be typewritten or printed in ink. All other entries will be in the rater's or endorser’s (as applicable) own handwriting. Any changes or erasures will be initialed by the rater or endorser, as appropriate.

(2) In the event that additional space is required for

entries under Item Nr 15, "ACTUAL OBSERVATION", enter in the appropriate item the word "oontinued", resume on (M) bond paper, and attach as a continuation sheet.

b. Responsibility in Preparation and Handling

(1) Appraisal Reports will not be folded and will be placed in an envelope suitab1e for. flat mai1ing. On1ythree (3) copies will be prepared; copies or extract will not be made at any echelon of command.

c. Forwarding

(1) When completed, the original will be forwarded to the Adjutant General, AFP and the duplicate to the Adjutant General of the parent Major Service of the rated officer and the triplicate to the rated officer. For JAGS, MC, DS, CHS, NC, MAC, VC,WAC, Corps of Prof and DOL officers assigned to the Major Service and AFPWSSUs, the original will be forwarded to TAG, AFP and the duplicate will be returned to the unitJ division where they are placed on duty and the triplicate to the rated officer.

(2) The accomplished report shall be

classified"Confidential" and shall contain a cover sheet for such classification. It shall be handled "safehand" by only four personnel in the command, i.e. Rater, Indorser, Rated Officer and Unit Personnel Officer prior to submission

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to the Major Service Adjutant andl or the Adjutant General, AFP.

(3) In case the report contains unfavorable entries that need reference to the rated officer, the report will be forwarded as prescribed in paragraph 11 below. Report should reach the Adjutant General, AFP and the Major Service Adjutant General not later than thirty (30) days after the last date of the period reported. Any report not forwarded within this time limit will have, attached thereto, an explanation or reason for the delay. If during combat 0 other emergency conditions an Appraisal Report is not completed when due, the responsible commander wilt ensure that the report is completed and submitted at the first opportunity.

(4) Since battle or other conditions or stress are the most important tests of the necessary qualities of leadership, it is of paramount importance that commanders render reports at the earliest possible time.

(5) The Adjutant General, AFP and the Adjutant General of the Major Services win designate an officer in their respective offices to take charge of the receipt, recording, and filing of all Appraisal Reports. TAG, AFP will make appropriate arrangements as to preparation and forwarding of Appraisal Reports rendered by reporting officers of schools and civilian agencies.

9. ADMINISTRATIVE INSTRUCTIONS IN ACCOMPUSHMENT OF AFP OFFICER APPRAISAL REPORT FORM AFP AGO 67 -M revised - (If there is not enough basis on which to rate the officer, items 9-13 win not be filled up)

a. Item 1 - Enter the name of the rated officer exactly as it appears in the official roster of the AFP.

b. Item 2 - Enter the rated officer's permanent grade. If the officer

is hOlding a temporary grade, indicate it in parenthesis. c. Item 3 - Enter the rated officer's Armed Forces Serial Number. d. Item 4 - Enter the branch of service (PA. PAF, PN and Technical

Services) e. Item 5 - Enter the rated officer's unit, organization and station. f. Item 6 - Enter the period covered by the report, i.e. from the date

the rated officer is on duty with the unit if this is the first Evaluation Report to be rendered for him in that unit, or the date following the last day covered by the last Evaluation Report if he has previously been rated in the same unit, to the end of the period the report is accomplished. Indicate also the number of days the rated officer performed the duties covered by the report.

g. Item 7 - Enter the duty assignment assumed by the rated officer

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for the period of the report, status of the duty position as to whether it is primary or additional (given in addition to his primary or main duty responsibility), period rendered in such duty, and the authorized T/O grade for the duty position.

h. Item 8 – Mark with an “X” the appropriate block as described in paragraph 5.

i. Item 9 - Mark with an 'X" the appropriate space or spaces

provided for depending on the basis for entries in this report. j. Item 10 - Rate the officer on the various attributes and

performance of duties in the degree you consider applicable to him and place the appropriate number as given in the space provided for in items 11-12.

k. Items 11 & 12 - Mark the appropriate space provided for with the

corresponding rating as indicated in item 10. Use the Unknown (0) only if the nature of contact makes it impracticable to make an estimate of his probable performance in a particular duty. Making Unknown (0) does not prejudice the rated officer.

l. Item 13 - Reflect the average rating obtained from items 1112 in

the space provided. Compute separately the rater's and the endorser are overall average and put it in the space provided. In case .Unk" is included in the rating, the average must be based on items with numeric ratings only. The average is the sum of all numeric ratings, divided by the number of numeric ratings entered. The quotient shall be rounded to the first decimal.

m. Item 14 - Reflect the overall observation on the actual performance, potentials for promotion and assignment and value to the service of subject officer. The observation shall be made by the Rater and Endorser in their own words and handwriting.

n. Item 15 - Input any comment which will increase the objectivity

of the rating. Include strengths and weaknesses not covered elsewhere in the report. Give factual and specific information. Comments will reflect major strengths, weaknesses, behavior, personality, character or other qualities which distinguish the rated officer. Mark an “X" on the appropriate space as applicable.

o. Item 16 - Certification by the rater and the endorser that entries

in the OAR conform with this Circular. p. Item 17 - This space is to be accomplished by the rated officer if

any item in the report is marked a 1" or when any serious deficiency or misconduct is stated in item 16 (comments).

q. Item 18 - If there are enclosures like reports of commendation or

adverse performance, attach a copy of each to this report. The number of enclosures will be indicated in Arabic numerals when there are no enclosures,

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the word "NO" will be entered in the space provided.

r. Item 19 - Upon receipt of the Appraisal Report, the appropriate unit personnel officer will examine the entries for accuracy and correctness, especially for errors in the personal data of the officer concerned. He will enter the rating in the appropriate space of the AFP AGO Form 66 for the rated officer and indicate the date.

s. Item 20 - Enter the unit personnel officer's grade, name, and

Armed Forces serial number. He will sign over printed name.

10. ADMINISTRATIVE GUIDE - To educate and guide the raters or endorsers, following are the parameters and their adjectival equivalents.

Rating Adjectival Equivalent 5 (Outstanding) - Maintains high standard of performance in

all areas of his job. Contributes very well in other areas of his job.

4 (Very Satisfactory) - Always meets all job-requirements and excels in most areas of his job.

3 (Satisfactory) - Meets normal requirements and job standards. Needs further training and self- improvement to be able to assume higher responsibilities

2 (Unsatisfactory) - Sometimes deficient on important job requirements and standards. Needs further training and self- improvement to remain in . the present job. UNK (Unknown)

.

- Rater has no knowledge about the performance or service reputation of the rated officer

11. UNFAVORABLE ENTRIES - Whenever an Appraisal Report

contains entries of “1” which is considered in any sense unfavorable, the reason for the entry will be clearly stated. The rater shall refer the entire report direct to the rated officer for his remarks. The rated officer will immediately return it to the rating officer by endorsement with his remarks pertaining to the unfavorable entries only. The report will then be forwarded to the endorser by the rater with his remarks with reference to the remarks on the rated officer. The rated officer will forward the entire report with his comments and or explanations to the endorser through the rater. If the report is delayed for more than fifteen (15) working days when referred to the rated officer or the rater, a brief memorandum explaining the delay will be attached. Likewise, a rating of "5" (Outstanding) needs justification (s) by the rater/endorser in a separate paper which must be indicated in item 18 of the OAR.

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12. RELEASE OF INFORMATION - Appraisal Report will be furnished only to personnel boards and career management authorities for use at Major Service headquarters level and above for personnel action and also to the rated officer. The Report shall be classified as “Confidential”.

13. FORMAL INSTRUCTION - The PMA, PAFFS and all service schools in the AFP will include this in the curricula of all officer courses being conducted. At least a two (2) hour formal instruction shall be spent on the proper preparation and accomplishment of Appraisal Reports.

14. RESCISSION - Circular Nr 22, this Headquarters dated 14 Oct 1987 is hereby rescinded.

15. AFP OFFICER APPRAISAL REPORT ON AFP STUDENT OFFICERS.

AFP OFFICER APPRAISAL REPORT (To be accomplished on AFP Student-Officers)

1. LAST NAME FIRST NAME MIDDLE INITIAL 2.GRADE 3.AFPSN 4. BR OF SVC 5. PARENT UNIT 6. COURSE PURSUED 7. DURATION OF COURSE 8. PERIOD OF DETAIL WITH SCHOOL 9. GRADUATED NOT GRADUATED (State reasons) 10. SCHOOL RECORD PASSING GRADE MAXIMUM MINIMUM SUBJECT TAKEN MAXIMUM POINTS POINTS RECEIVED GRADE IN PERCENT FINAL RATING 11. HONORS AND AWARDS RECEIVED 12. GRADUATION STANDING NR________ IN A CLASS OF _______ 13. POTENTIAL INSTRUCTOR 14. RECOMMENDED FOR HIGHER SCHOOLING 15.COMMENTS ON THE WEAKNESSES, STRENGTHS, BEHAVIOR, PERSONALITY, CHARACTER AND OTHER ATTRIBUTES OF THE OFFICER WHICH MAY BE DEEMED NECESSARY TO BE INCLUDED IN THIS REPORT. 16. REPORTING OFFICER’S GRADE, NAME, SERIAL NUMBER, BR OF SVC, POSITION AND ORGANIZATION.

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17. DATE ACCOMPLISHED 18. SIGNATURE OF REPORTING OFFICER 19. DATE ENTERED ON AGO FORM NR 66 20. PERSONNEL OFFICER GRADE NAME, AFPSN AND SIGNATURE AGO FORM NO 67-U (REVISED) INCL B TO CIR NR 4 GHQ, AFP DTD 05 MAY 2003

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ANNEX G AFP REGULATIONS AFPRG G-112-610 (approved by SND 18 Apr 05) DEPARTMENT OF NATIONAL DEFENSE GENERAL HEADQUARTERS ARMED FORCES OF THE PHILIPPINES Camp General Emilio Aguinaldo, Quezon City

CAREER DEVELOPMENT PROGRAM FOR NURSE CORPS OFFICERS IN THE AFP

Paragraph General - - - - - - - - 1 References - - - - - - - - 2 Purpose - - - - - - - - 3 Definition of Terms - - - - - - - - 4 AFP Occupational Specialty Standards for Nurse Corps - - - - - - - - 5 Maintenance of Qualification Files - - - - - - - - 6 Nurse Co0rps Career Pattern - - - - - - - - 7 Career Management - - - - - - - - 8 Exemption Clause - - - - - - - - 9 Rescission - - - - - - - - 10 Effectivity - - - - - - - - 11 1. GENERAL: This AFPR prescribes the Career Development Program for Nurse Corps Officers in the Armed Forces of the Philippines. It establishes the regulatory guidelines aimed to enhance the professional capabilities for positional advancement in line with their projected designations through the implementation of training courses and progressive duty assignment under the supervision of the Office of The Chief Nurse, AFP. 2. REFERENCES:

a. RA 9173, the Philippine Nursing Act of 2002

b. AFPR G 125-022, RP DND GHQ AFP dated 15 June 1991, Subject: AFP Occupational Classification and Structure

c. Board of Nursing Board Resolution no. 425 Series of 2003;

Implementing Rules and Regulations of the Philippines Nursing Act of 2002, RA 9173

d. AFPR G 161-072 dtd May 1991, Subject: Table of Organization

and Equipment Nr G 08-9.

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e. AFPR G 100-012 dtd 1 April 1986, Subject: AFP Regulations

General Provisions. f. Cir Nr 4 GHQ, AFP dtd 05 May 2003, Subject: AFP Officer

Appraisal System. (Cir Nr 4 GHQ, AFP dtd 05 May 2003) g. AFP Standards of Nursing Practice 1987. h. PAM 1-05 Philippine Army Nursing Service Administration

Manual (March 2001). i. Philippine Air Force Manual, PAM-17-1, Aircrew Management,

July 1978. j. Nursing Specialty Certification Program Board of Nursing

Resolution No. 14 S1999 k. Guidelines for Implementation BON Resolution No.118 S2002.

3. PURPOSE:

This regulation prescribes the procedures for the classification, proficiency designation, career pattern and management, awarding of AFP Occupational specialty, and accreditation of non – AFP specialty training of Nurse Corps Officers. 4. DEFINITION OF TERMS:

a. Career Development Pattern/ Career Ladder - progressive

levels of command and staff positions where the Nurse Corps Officer has to be trained and assigned upon entry and while in the active service.

b. Armed Forces of the Philippines Occupational Specialty

(AFPOS) - Term used to identify duty positions for NC Officers stated in Annex A, AFPR G 125. The basic classification has three (3) digits, namely: the numerical 32 which is assigned to the Nurse Corps and the alphabetical digit that corresponds to the field of concentration, e.g. Nursing Service Administrator is 32A.

c. Standards of Nursing Practice – AFP doctrine that incorporates the structure, process and outcome components of the delivery of quality and safe nursing care as based on the PNA and AFP Standards of Nursing Practice (AFP Standards of Nursing Practice, 1987

d. Qualifications File – Documents maintained at the Office of the

Chief Nurse Major Services/ AFPWSSUs for every Nurse Corps Officer within their jurisdiction. It is composed of the career pattern worksheet, initial curriculum vitae, classification, training, evaluations in assignments, re-evaluation of AFPOS, changes, and accompanying orders. Duplicate copies

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are available at the Office of The Chief Nurse, AFP to ensure that the prescribed career patterns are followed.

e. Proficiency – Level of competence in the occupational nursing specialty based on educational preparation, work experience, satisfactory performance in the profession, and scientific contribution for the improvement of the Nursing Specialty through research. There are four (4) levels: beginner (Delta), competent (Charlie), proficient (Bravo), and expert (Alpha). These proficiency designations are spelled out after the three digit AFPOS separated by the symbol dash. This does not apply to the Flight Nurse and

General Duty Nurse. e. g. Nursing Service Administrator, proficiency D

is written 32A – Delta. f. Nursing specialties – different fields of specialization in nursing

where Nurse Corps Officers may choose to train and serve, as enumerated in para 5a (except General Duty Nurse).

g. Primary AFPOS –refers to the specialty currently practiced by

the NC Officer in which he is most qualified to perform. h. Secondary AFPOS - refers to the specialty which is less

practiced by the Nurse Corps Officer after having been designated as such. i. Additional AFPOS – The AFPOS which an AFP nurse is next

best qualified to perform after the secondary AFPOS.

j. Career Courses - mandatory military courses (Basic, Advance, General Staff Course).

k. Officer Appraisal Report (OAR) – Semi-annual report for officers’

evaluation and measurement of his effectiveness and value to the service as embodied in GHQ Cir Nr 4 dated 05 May 2003, Subject: AFP Officer Appraisal System.

l. Competency Assessment Checklist – current tool used to

measure the AFP nurses’ competency level in the professional nursing skills required at different specialties. 5. AFP OCCUPATIONAL SPECIALTY STANDARDS FOR NURSE

CORPS: a. The following are the basic AFPOS classification for military

nurses:

(1) Nursing Service Administrator 32A (2) Flight Nurse 32B (3) Psychiatric Nurse 32C (4) Communicable Disease Nurse 32D (5) Pediatric Nurse 32E (6) Operating Room Nurse 32F

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(7) Orthopedic Nurse 32G (8) Anesthesist 32H (9) Obstetrical Nurse 32I (10) Renal Nurse 32J (11) Neurosurgical Nurse 32K (12) General Duty Nurse 32L (13) Critical Care Nurse 32M (14) Cardiac Catheterization Nurse 32N (15) Nuclear Nurse 320 (16) Community Health Nurse 32P (17) Nurse Educator 32Q (18) Trauma Nurse 32R (19) Oncology Nurse 32S

b. AFPOS 32B Flight Nurse and 32L General Duty Nurse are

exempted from proficiency designations stated herein. General Duty Nurse is an entry classification for a newly called to active duty (CAD) Nurse Corps officer who has no training in other nursing specialties indicated in para 5a. On the other hand, Flight Nurse shall follow the standard three level designations, with requirements as indicated:

(1) Flight Nurse-awarded to those who have successfully

completed the Flight Nurse Course locally or abroad or its equivalent; received the certificate of proficiency after completion of at least one hundred (100) hours of certified flying time in military aircraft either in training or actually performing flight nurse duties aboard the aircraft; and on flying status to perform flight nurse duties or as student flight nurse.

(2) Senior Flight Nurse-awarded to the Flight Nurse who has

been designated for at least seven (7) years as Flight Nurse in the Armed Forces of the Philippines, has logged at least eight hundred (800) hours certified flying time in military aircraft performing primary flight nurse duties and on flying status as a flight nurse.

(3) Senior Flight Nurse-awarded to the Flight Nurse who has

been designated for at least seven (7) years as Flight Nurse in the Armed Forces of the Philippines, has logged at least eight hundred (800) hours certified flying time in military aircraft performing primary flight nurse duties and on flying status as a flight nurse.

(4) Chief Flight Nurse-awarded to the duly designated Chief

Nurse Air Force, or those who have been designated for fifteen (15) years as flight Nurse and or Senior Flight Nurse, have logged one thousand five hundred (1,500) hours of certified flying time in military aircraft performing primary flight nurse duties and on flying status as a Senior Flight Nurse.

c. Proficiency Designation (Enclosure 1)

(1) Proficiency Delta – lowest level of proficiency awarded to the beginner (1 year) in the specialty. Requirements include satisfactory

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ratings in performance (Officer Appraisal Report) and competency (Competency Assessment Checklist); and certified successful management of the required number of cases in the specialty: (50 cases in Communicable Disease, Renal, Neurosurgical Nursing; 75 cases in Psychiatric, Pediatric, Operating Room, Obstetric, Critical Care, and Oncology Nursing; 100 cases in Trauma Nursing and 1,000 clients in Community Health Nursing. Additional/ other requirements are needed for the following AFPOS classifications:

(a) Nursing Service Administrator (32A-Delta) – Five (5) years minimum active military service, satisfactory performance in any of the following positions for one (1) continuous year and nine (9) units post graduate requirements for the degree leading to Master of Arts in Nursing:

• Chief Nurse of twenty -five (25) bed hospital

• Supervisor of fifty (50) bed hospital • Chief Administrative / Chief Personnel

Management Branch of a fifty (50) bed hospital.

(b) Nurse Educator (32Q-Delta)- Five (5) years

minimum active military service, completion of the Nurse Educator Course or its equivalent as determined by the Board, and satisfactory performance as Training Officer in any AFP training facility for at least six (6) continuous months .

(2) Proficiency Charlie – awarded to those competent (3

years) in the specialty, have completed nine (9) units post graduate course leading to Master of Arts in Nursing, have accumulated 30 contact hours of training in the specialty, have received very satisfactory ratings in performance (Officer Appraisal Report) and competence (Competency Assessment Checklist), and have been certified to successfully manage the required number of clients (100 in Communicable Disease, Renal, Neurosurgical Nursing; 150 in Psychiatric, Pediatric, Operating Room, Obstetric, Critical Care, Oncology Nursing; 200 in Trauma Nursing and 2,000 clients in Community Health Nursing). Other requirements needed for the following AFPOS classifications are as follows:

(a) Nursing Service Administrator (32A-Charlie) Ten

(10) years minimum active military service, successful completion of the Career Advance Course and academic requirements of post graduate course leading to Master of Arts in Nursing, and very satisfactory performance for one (1) continuous year in any of the ff positions:

• Chief Nurse of fifty (50) bed hospital • Assistant Chief Nurse of a hundred (100)

bed hospital

• Supervisor of tertiary hospital

• Chief Administrative and Personnel Management Branch in the Major Service.

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(b) Nurse Educator (32Q-Charlie)-Ten (10) years minimum active military service, satisfactory performance for two (2) years as Nurse Educator/ Trainer, completion of the Career Advance Course and eighteen (18) units of Master in Nursing/ Education course from college/university duly recognized by the government of the Republic of the Philippines.

(3) Proficiency Bravo – awarded to those proficient (5 years)

in the specialty, have completed the academic requirements for Master of Arts in Nursing, have received excellent ratings in performance (Officer Appraisal Report) and competency (Competency Assessment Checklist), and successfully completed five hundred (500) certified teaching/training hours in the specialty. Other requirements needed for the following AFPOS classifications include:

(a) Nursing Service Administrator (32A-Bravo) -Eighteen (18) years minimum active military service, successful completion of the General Staff Course and Master in Nursing degree, and very satisfactory performance for two (2) continuous years in any of following positions:

• Deputy Chief Nurse, Major Services / AFP Medical Center

• Chief Nurse of a hundred (100) bed hospital

• Assistant Chief Nurse of tertiary hospital

• Chief Administrative and Personnel Management Branch, Office of The Chief Nurse, AFP

(b) Nurse Educator (32Q-Bravo) - ten (10) years minimum active military service, completion of the General Staff Course and Master of Arts in Nursing / Education, and have satisfactorily designed/ implemented/evaluated training programs for nursing and paramedical personnel for five (5) continuous years.

(4) Proficiency Alpha – – awarded to the experts (10 years) in the specialty, NC officers who achieved prominence comparable with civilian nursing leaders. With Master of Arts in Nursing degree, with individual scientific contribution to Military Nursing through research and / or significant publication, have received outstanding ratings in performance (Officer Appraisal Report) and competency (Competency Assessment Checklist), and have successfully completed eight hundred (800) certified teaching / training hours in the specialty. Other requirements needed for the following AFPOS classifications include:

(a) Nursing Service Administrator ( 32A-Alpha ) - awarded to The Chief Nurse, AFP upon assumption, and to others with twenty five ( 25 ) years minimum active military service, completed the General Staff Course and Master of Arts in Nursing degree, preferably with Master in National Security Administration ( MNSA ) or Doctorate degree,

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with individual scientific contribution to Military Nursing through research and/or other significant publication, and have served very satisfactorily in any of the following positions for two ( 2 ) continuous years:

• Chief Nurse of Major Services / VLGH

• Chief Nurse of Major Services / VLGH

• Command Nurse, AFP Medical Center / Area Commands

• The Deputy Chief Nurse, AFP

(b) Nurse Educator (32Q-Alpha) – awarded to NC Officers with twenty- five (25) years minimum active military service, completed the General Staff Course and Master of Arts in Nursing / Education or degree, with individual scientific contribution through research and/or significant publication, and have served very satisfactorily in any of the following positions for two (2) continuous years:

• Chief, Education and Training Branch

OTCN

• Assistant Commandant of AFP Training School

• Assistant Chief Nurse, Education and Training Branch of a tertiary hospital.

6. MAINTENANCE OF QUALIFICATION FILES:

a. Chief Nurses of the Major Services/ AFP Wide Service Support

Units shall maintain the qualifications file of each Nurse Corps Officer assigned or detailed within their technical jurisdiction. These records will be composed of the initial curriculum vitae or classification questionnaires for training details, ratings or evaluation in assignments, re-evaluation of AFPOS, orders for AFPOS, and subsequent changes thereof. Cover sheet for this file will be the career pattern worksheet.

b. The monitoring office, Office of The Chief Nurse( OTCN), Armed

Forces of the Philippines will be provided a copy of the qualifications file for each Nurse Corps officer by the Major Service/ AFPWSSUs Chief/ Command Nurses and with all subsequent data that belong to the file as prescribed. 7. CAREER PATTERN:

a. General: Upon Call to Active Duty, Nurse Corps Officers shall be assigned at a general hospital / medical center and designated General Duty Nurse.

b. Training Courses:

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(1) All newly Called to Active Duty officers shall attend the

Technical Services Officers Basic Course preferably within the first year of tour of active duty.

(2) Between the fifth to eighth (5th-8th) year, NC officers shall

attend the Technical Service Officers Advance Course or its equivalent, locally or abroad.

(3) All NC Officers who have shown executive and

leadership abilities shall attend the General Staff Course , locally or abroad, preferably between the twelfth to fifteenth (12th-15th) year of active duty and with the rank of Major only.

(4) NC Officers occupying top positions who have

demonstrated exceptional professional ability may attend the Master of National Security Administration (MNSA), locally or abroad, preferably on the twenty- first (21st) year of tour of active duty (rank of LTC to COL).

c. Specialty Training/ On-the-Job Training:

(1) NC Officers who are in active service and have graduated from the Technical Service Officers Basic Course, are eligible to apply or may be chosen by the Chief Nurse, Major Service / AFPWSSUs for specialty training conducted at civilian or military installations, locally or abroad. These courses include Nursing Service Administration, Flight Nursing, Psychiatric Nursing, Communicable Disease Nursing, Pediatric Nursing, Operating Room Nursing, Orthopedic Nursing, Anesthesia Nursing, Obstetrical Nursing, Renal Nursing, Neurosurgical Nursing, Critical Care Nursing, Cardiac Catheterization Nursing, Nuclear Nursing, Community Health Nursing, Nursing Education, Trauma Nursing, and Oncology Nursing.

(2) Specialty Training/ On-the-Job Training is a continuous

and ongoing process for the NC Officers.

d. Developmental Profile: The Nurse Corps Career Pattern tabulated in enclosure 2 shows the phases of professional advancement, training requirements and progressive positional assignment of NC officers commensurate to their military ranks, based on the empirical data monitored throughout the various regions in the country. NC officers are expected to have an excellent foundation in clinical nursing before receiving diversified assignments. Although not all NC officers maybe slated for diversified assignments, they are nevertheless, given the opportunity to advance in their chosen field of specialization.

e. Requirements:

(1) This administrative function shall be assumed by the office of the Chief Nurse from the different Major Services, to include AFPWSSUs, with the task of ensuring the strict compliance to the

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established regulations and facilitating the required training and projected assignments for Nurse Corps Officers envisioned to develop their utmost potentials.

(2) Training and duty assignment shall be progressive as

indicated in para 7. (3) Re-evaluation of officers’ AFPOS shall be done yearly, at

the same time as the officers’ evaluation at the end of the year, by the Chief Nurse of Major Services and AFPWSSUs or through a designated cognizant representative.

(4) A career pattern worksheet shall be prepared for each

NC Officer to include his/ her previous assignments and the plan for his/ her future assignment for the normal thirty-(30) year career period or up to the time he/ she reaches fifty six (56) years of age. This will form the cover sheet of the individual classification file.

f. Awarding of the AFPOS:

(1) Chief Nurse of Major Services and AFPWSSUs will submit their recommendations using the prescribed format (Enclosure 3) to The Chief Nurse, AFP Attention: Chief, Training Branch exactly first quarter (1st Qtr) of the year.

(2) The Chief Nurse, AFP upon receipt of the

recommendations will convene the Board to deliberate on the recommendees in the second quarter of the year. The Board shall be composed of the following: The Deputy TCN, AFP; Chief, Administrative and Personnel Management Branch OTCN; Chief, Training Branch, OTCN; Deputy Chief Nurse of Major Services and the Command Nurse of the AFP Medical Center and representatives from J1 and J3.

(3) The Board will deliberate and recommend prospective awardees to The Chief Nurse, AFP for approval.

(4) Appropriate orders will be issued in the third quarter of

the same year. (5) Certification from previous unit/ employer as to how many

hours was spent in the practice and the list of cases handled/ assisted, training designs implemented, and others which the Board may require.

g. Responsibilities:

(1) Deputy Chief of Staff for Personnel, J1 in coordination with The Chief Nurse, AFP monitors the career development for Nurse Corps officers of the Armed Forces of the Philippines.

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8. CAREER MANAGEMENT:

a. Requirements:

(1) This administrative function shall be assumed by the Office of The Chief Nurse, AFP and Chief Nurses from the different Major Services, to include AFPWSSUs, with the task of ensuring strict compliance to the established regulations and facilitating the required training and projected assignments for Nurse Corps officers envisioned to develop their utmost potentials.

(2) Training and duty assignment shall be progressive as

indicated in para 8. (3) Re-evaluation of officers’ AFPOS shall be done yearly, at

the same time as the officers’ evaluation at the end of the year by the Chief Nurse, Major Services and AFPWSSUs or through a designated cognizant representative. A career pattern worksheet shall be prepared for each NC officer to include his/ her previous assignments and the plan for his/ her future assignment for the normal thirty- (30) year career period or up to the time he reaches 56 years of age. This will form the cover sheet of the individual classification file.

b. Awarding of the AFPOS:

(1) Chief Nurse of Major Services and AFPWSSUs will submit their recommendations using the prescribed format (Enclosure 3) to The Chief Nurse, AFP Attention: Chief, Training Branch exactly first quarter (1st Qtr) of the year.

(2) The Chief Nurse, AFP upon receipt of the

recommendations will convene the Board to deliberate on the recommendees in the second quarter of the year. The Board shall be composed of the following: The Deputy TCN, AFP; Chief, Administrative and Personnel Management Branch OTCN; Chief, Training Branch, OTCN; Deputy Chief Nurse of Major Services and the Command Nurse of the AFP Medical Center and representatives from J1 and J3.

(3) The Board will deliberate and recommend prospective

awardees to The Chief Nurse, AFP for approval. (4) Appropriate orders will be issued in the third quarter of

the same year.

c. Accreditation of Non-AFP Specialty Training: NC officers who have undergone specialty training prior to call to active duty (CAD) shall be classified accordingly upon satisfaction of the following requirements:

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(1) Completion of the Didactic Phase of the AFP Specialty Training Course.

(2) Certification from previous unit/ e

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NC CAREER MANAGEMENT The Chief Nurse, AFP under the authority of the Chief of Staff, AFP and the technical supervision of Deputy Chief of Staff for Operations, J3, monitors, supervises and coordinates the career development of NC Officers. Major Services/ AFPWSSUs Chief Nurses are responsible for the continuous review of AFPOS of military nurses under their supervision. Nurse Corps officers concerned are equally responsible in assuring that their assignments and training follow the prescribed career pattern. 1. Military Education

a. Technical Service Officers Basic Course (TSOBC) - is a military training conducted in two phases- the general military and specialization phases. This course gives emphasis on AFP health policies, procedures, practices and Field Medical Service Support to AFP operations.

1) Course Location:

Military Phase: Combat Arms School, Philippine Army Training Command, Fort Magsaysay, Palayan City, Nueva Ecija. Specialization Phase: AFP Medical Service School, V Luna Rd, Quezon City.

2) Duration: 14 wks 3) Prerequisites:

(a) NC Officers in the active service of the AFP who

have not undergone TSOBC or its equivalent. (b) Must be physically and mentally fit for general

military service. (c) Has no pending case both in civil or military court. (d) Must not be due for ETAD during the duration of

training for reserve officers. (e) Female officers must not be pregnant during the

duration of the course.

b. Technical Service Officers Advanced Course (TSOAC) - is a two-phased military training ( Military and Nurse Specialization) designed to equip Nurse Corps Officers with the needed military leadership, managerial and administrative skills as middle level managers.

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1) Course Location:

Military Phase: Combat Arms School, Philippine Army Training Command Fort Magsaysay, Palayan City, Nueva Ecija Specialization Phase: AFP Medical Service School, V. Luna Rd, Quezon City

2) Duration: 14 weeks 3) Prerequisites:

(a) Must be with the rank of O-3 to O-4 and in the

active service (b) Has no pending administrative, criminal or

court martial case (c) Physically and mentally fit for training (d) Physically and mentally fit for training (e) Must have satisfactorily completed the

Technical Service Officers Basic Course. (f) Must not be due for ETAD during the duration

of training. (g) Female officers must not be on the family way

during the duration of the course.

c. Command and General Staff Course (CGSC) - is designed to prepare selected senior officers to assume command and staff positions in their respective organizations.

1) Course Location:

AFP Command and Staff College, Camp Gen Emilio Aguinaldo, Quezon City

2) Duration: 10 months

3) Prerequisites:

- Recommendation from Major Services Command and Chiefs of Technical

Services:

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(a) Must have satisfactorily completed the Technical Service Officers’ Advance Course;

(b) Must have at least five (5) more years of service

remaining before his/ her compulsory retirement reckoned from graduation date of the course;

(c) An average of “satisfactory” performance or

rating of 3 in one’s OARs for the last 3 years; (d) Has no pending civil, administrative, criminal or

court-martial case; (e) Must secure security clearance for access at

least to “SECRET” documents/materials; (f) Cleared from all property and money

accountability responsibilities; (g) Must be physically and psychologically fit; (h) Must pass the qualifying examination being

administered by AFP CGSC.

d. Masters in National Security Administration – This course broadens the perspective of officers at an early stage in their career aside from providing preferential consideration for assignment to key and sensitive military positions.

1) Prerequisites:

(a) Must be recommended by Major Service Commander and Chief, Technical Service.

(b) Must have a minimum rank of O-5. (c) Must be CGSC eligible and belongs to the upper

50% of his class. (d) Must not be more than 51 years of age upon

admission with 3 years of service remaining prior to compulsory retirement, to be reckoned from date of graduation. 2. Professional Nursing Education.

a. AFP Nurse Specialty Training Course.

(1) Purpose: To prepare Nurse Corps officers and AFP civilian nurses to function in specific nursing specialties at staff level position.

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(2) Location: Nursing Service Training Hall, V Luna General Hospital and AFP Medical Service School, AFP Medical Center, V Luna Road, Quezon City

Cross-training: UP-PGH; Philippine Orthopedic Center, Philippine Children’s Medical Center, Asia Renal Care Philippines, Inc.

(3) Duration: 48 wks

(4) Prerequisites:

(a) Rank of O-1, O-2, O-3 (b) Must have completed the required basic career

course.

(c) Must have current valid RN license.

(d) Must have a current IV Therapy license

(e) Must be willing to serve in any AFP medical installation after graduation for the period as stipulated in GHQ, AFP Circular No. 14 dtd 10 July 1990, subject: Contractual Service Obligation.

(5) Areas of Specialization:

(a) Community Health Nursing (b) Operating Room Nursing (c) Neuropsychiatric Nursing (d) Renal Nursing (e) Orthopedic Nursing (f) Neurosurgical Nursing (g) Critical Care Nursing (h) Maternal and Child Health Nursing (i) Pediatric Nursing (j) Trauma Nursing (k) Communicable Disease Nursing (l) Nursing Education (m) Nursing Administration (n) Flight Nursing

b. Flight Nurse Course - applicable to all NC officers on active

duty selected for training for Flight Nursing abroad.

(1) Prerequisites:

(a) Must be an active commissioned NC officer from any major service on GHQ & AFPWSSU’s.

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(b) Physically and mentally fit as determined by authorized AFP Medical Examining Board.

(c) Must have the rank of 1LT to Major (d) Must be a graduate of the Technical Officers

Basic Course or its equivalent in the Major Service commands.

(2) Utilization of Flight Nurse Graduates

(a) Upon completion of the course, the student shall be assigned in areas/ units where he/ she can be utilized in aero-medical evacuation missions for at least two (2) years for maximum utilization.

(b) Must serve as instructor in Basic Flight Nurse

Courses conducted locally and in military schools where his/ her services are needed.

(c) Must comply with the contractual service

prescribed for foreign schooling.

c. Short- Course Programs

(1) Pre-Chief Nurse Course - to enhance the knowledge, skills and attitudes of senior military nurses in preparation for position as Chief Nurse of AFP Hospitals

(a) Prerequisites:

• Must be with the rank of O-3 to O-5 with 4 years TIG to LTC.

• Must have completed the Basic and

Advanced Courses for Technical Service Officers. • Must be projected to assume the Chief

Nurse position in any AFP medical installation.

(2) Clinical Head Nurse Course - to prepare NC officers to function as head nurses in AFP medical facilities.

(a) Prerequisites:

• Must be with the rank of O-3 to O-4 with actual or anticipated assignment to a clinical head nurse position within any AFP medical facility.

• Must have a current valid RN license.

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• Must be recommended by respective Chief Nurses of the different Major Services and AFPWSSUs.

(3) Advanced Nursing Admin Course - to prepare NC

officers to function in advance management roles in AFP medical installations.

(a) Prerequisites:

• Must be with the rank of O-5 to O-6 • Must have an actual or anticipated

assignment that involves advance nursing administration. • Must have completed the Technical

Service Officer’s Advanced Course. • Must have a current and valid nursing

license.

(4) Faculty Development Course- is a two-phased program designed to equip potential Nurse Corps officers with the necessary knowledge, skills and attitude required of a trainer.

(a) Location: AFP Medical Service School,

AFPMC V Luna Rd Quezon City. (b) Duration: 2 weeks

(c) Prerequisites:

• Must be with the rank of O-3 to O-6. • Must have an actual or anticipated

assignment in areas involving nursing education. • Must have completed the Nurse Corps

Officer Advanced Course. • Must have a current and valid nursing

license issued by PRC. 3. CIVILIAN POST GRADUATE EDUCATION

a. Masters Degree in Nursing- this course is designed to improve the quality of nursing education and practice by developing and increasing the competence of nurse managers. This is mandated by RA 9173 “Philippine Nursing Act of 2002” with 2005 as year of implementation.

(1) Prerequisites:

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(a) Must have a valid and current PRC license. (b) Must qualify in the admission examination

administered by the school. (c) Must possess knowledge and ability to carry on

an investigation of a significant problem or the application of a theory in a certain field.

(2) Additional Requirements: Must comply with academic requirements of the program as.

(a) Must have a general weighted average of

“2.0”,”B”,”86” or better in the undergraduate program. (b) Must have at least two years of successful

professional experience in education or in allied fields. (c) Must have passed the graduate admission

examinations prescribed by the college. (d) Must have a superior command of the English

language, both in oral and written form.

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R E S T R I C T E D H-1

ANNEX H

POLICIES GOVERNING MARRIAGE, PREGNANCY AND MATERNITY LEAVE OF FEMALE MEMBERS OF THE ACTIVE FORCE OF THE AFP

AUTHORITY: AFP Regulations G 131-352 dtd 22 Jun 95

Marriage

1. Any female member of the Armed Forces of the Philippines who contracts marriage, is allowed to continue her service provided that prior to such marriage, she has already completed at least three (3) years of continuous active military service.

2. Any female member of the AFP who shall many before

completing three (3) years of continuous active service, shaft automatically be reverted discharged from the service, provided further, that any female member of the AFP who W8$ previously separated reverted discharged honorably by reason of marriage may be called to active duty or reinstated if such marriage was contracted after three (3) years of continuous active military service.

3. Marriage between commissioned officer and enlisted personnel

is permitted, provided, that the female member of the Armed Forces of the Philippines shall have completed at least three (3) years of continuous active military service. Provided further that separation of unit assignments of prospective couple who are assigned with the same unit shall be effected upon contracting the marriage.

4. Military personnel who contract marriage without written permission from appropriate authority shall:

a. Be referred to the appropriate Efficiency and Separation Board in case of regular officers.

b. Be reverted to inactive status upon expiration of current

tour of duty in case of reserve officers.

5. Any unmarried female commissioned officer who becomes pregnant or has been positively found to have given birth or had a miscarriage or abortion shall be reverted discharged from the service. Provided that in case of a regular or reserve officer who has satisfactorily rendered a total of ten (10) years of continuous active commissioned military service, her case shall be referred to the appropriate ESB. Maternity Leave

1. Married female member of the AFP shall be entitled to sixty (60) days of maternity leave with fun pay. It shall be granted in every instance of pregnancy, irrespective of frequency.

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2. Any married female member of the AFP who has suffered miscarriage or abortion, shall be made to apply for maternity leave which is effective one (1) month prior to the expected date of delivery or confinement or on the date of occurrence and/or confinement or hospitalization.

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ANNEX I

GENERAL HEADQUARTERS ARMED FORCES OF THE PHILIPPINES

Camp General Emilio Aguinado Quezon City

14 January 2005 (Date) Circular Nr 01 SUBJECT: AFP Technical Services Uniform TO: See Distribution

To achieve uniformity and strong sense of identity and pride among members of the AFP Technical Services, a common uniform is hereby prescribed for all members.

1. Formal Dress Uniforms

a. Evening Dress Uniform (Mess Jacket). Also known as Black & White uniform, the mess jacket is the standard formal evening uniform for the Technical and Administrative Services of the AFP. Male officers shall wear the black jacket white the female officers shall wear the white jacket blouse. This is worn during formal military evening dinner’s receptions and balls and such other functions that can for the wearing of the mess jacket, equivalent to the civilian formal coat and tie attire. It is a three- piece ensemble consisting of black white coat jacket a black long pants, ankle length skirt and white inner long sleeves shirt blouse.

(1) Jacket - The shade is black/white coat jacket made

of 55% polyester and 45% tropical wool fully lined straight back and single breasted with 6 big AFP brass buttons attached on both sides and 2 small AFP brass buttons connected to a 5 an chain for front closure.

(2) Trouser - The trousers is in deep back shade of

matching material with the jacket. It is high-waist without pockets. The bottom of the male trousers' legs rests on the front of the shoes with a slight break in creases. The back of the trouser legs extends approximately 1.27 cm longer than the front.

(3) Shirt- For male personnel, the shirt is long sleeves

trubenized-style, conventional dear white soft dress with standing turn down collar and French cuffs. It is front-pleated w front-pleated with open edge of pleats facing inward. The front opening is secured by black rounded buttons. For female personnel, the inner blouse is the same as for the male, except

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that the pleats are replaced by 3 rows of ruffles with gold trimming at the edge. The buttons at the center are rounded black buttons. Approximately 0.6 cm of the cuffs protrudes from the sleeves of the jacket when the hand hangs naturally on the side. The shirt is tucked-in to the skirts.

(4) Skirt - The skirt is of deep black shade of matching material with the jacket. The skirt is ankle length, straight hanging on pencil cut with no flare from hip to hem. The over lapping slit at the back should measure from 38 to 46 cm.

(5) Headgear- Pershing cap for males and black felt

cap for females. (6) Tie- For female personnel, a black satin crescent

neckband is attached under the front collar of the inner shirt. For males, deep black, silk satin, pre- tied bow tie.

(7) Cummerbund - A sash 12.7 em wide, in deep

yellow, satin shade, pleated without design for female officers and black sash for male officers. It is worn with open edge of pleats facing upward, and joined by a hook at the back.

(8) Footwear - The male personnel use the low

quarter black dress shoes. For female personnel, the shoes are of tapered heel not more than 7.62 em and not less than 5.10 cm in height in black shade, light gloss leather and skin tone nylon hosiery.

(9) Bag - Plain black patent leather clutch bag.

(10) Accoutrements:

(a) Shoulder boards with rank insignias (b) Miniature service specialty rating or service

command badge (c) Miniature medals worn centered on the left

lapel with the top of the holding bar at the lapel's widest part.

b. Dress White - Known as the White Duck, is a formal daytime uniform for all officers. It is worn during formal daytime military receptions and weddings, formal calls, ceremonies, during daytime state functions and formal affairs and when serving as pallbearers during interments and or neurological services. It is a three-piece ensemble consisting of a white single- breasted coat, white long pants or pencil - cut knee-length skirt and white long sleeves inner shirt or blouse.

(1) Coat - The coat is of traditional tailored design with

collar and lapel. It is made of clear white 55% polyester and 45% tropical wool material. The coat for females is single-breasted and conforms to the contour of the body but allows ease of movement. It has 2 hanging lower pockets without flaps and with arms hanging naturally, the sleeves end approximately

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1.27 cm from the heel of the thumb. The coat is fully lined, with white sleeve braid, 1.27 cm wide for company grade officers and 1.9 cm wide for field grade officers. The length of the coat is proportionate to the height.

(2) Trousers - The trousers is of matching shade and

material with the coat. The trouser for males is full-cut, straight hanging, with two side and back pockets and belt loops, cuffless and without pleats. The two back pockets are covered with flaps. The bottom front of the trousers' legs rests on top of the shoe with a slight break in the creases. The back of the trousers legs extends approximately 1.27 cm longer than the front.

(3) Skirt - The skirt is of matching shade and material

as the coat. It is knee high length, and should fit snugly but not tightly around the waist and hips. It has no pockets and with overlapping back slit and back closed by zipper.

(4) Shirt - The shirt is dear white, plain woven and

secured with small transparent plastic buttons. It has short pointed standing, turndown collar without button. When hanging naturally, approximately 0.6 cm of the cuffs of the sleeves protrudes from the sleeves of the coat. The shirt is tucked-in to the pants skirt.

(5) Headgear- Pershing cap for male personnel and black felt cap for female personnel.

(6) Tie - The tie for female personnel is black satin

crescent neckband with 1.5 cm width attached under the front collar of the shirt. The tie for male personnel is black satin and plain woven. It is a 4- hand tie without decoration and when worn, should hang naturally from the neck collar down to the waist and secured to the shirt with an AFP regulation cravat clasp.

(7) Footwear - the male personnel use the low quarter

black dress shoes. For female personnel, the shoes is of tapered heel not more than 7.62 cm and not less than 5.1 cm in height in black shade, light gloss leather and skin tone nylon hosiery.

(8) Bag - Plain black patent leather bag.

(9) Accoutrements

(a) Shoulder boards with rank insignias (b) AFP coat of arms (c) Awards and decorations (d) Service and special badges (e) Flight badge (f) Nameplate (g) Highest military schooling badge

c. Technical Service Blouse - This is the standard semi-

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formal day and evening attire for alt NC office uniform for all Technical Service officers. It is worn during semiformal day and night military functions and receptions. It is also worn during the AFP and major service anniversaries and fn other traditional military ceremonies which honor or have as principal guests a$ the President and Vice President or Heads of States, of government of other countries. It is a three-piece ensemble consisting of a dark-gray single-breasted coat, dark-gray pants pencil cut knee-length skirt and an inner off-white long sleeves shirt blouse. A black crescent neckband for is attached under the front collar female of the inner blouse for females and black tie for the males.

(1) Coat - The coat 15 of trad1tional tailored design,

made of dark gray 55% polyester and 45% tropical wool. The coat is single-breasted with no breast pockets, and conforms to the contour of the body but allows ease of movement. It is also closed with 4 large gilded brass AFP buttons and has 2 hanging pockets without flaps. With arms hanging naturally on the side, the sleeves will end approximately .06 cm from the heel of the thumb. The coat is fully lined, with black sleeve braid 1.27 cm wide for company grade officers and 1.9 cm wide for field grade officers. The length of the coat is proportionate to the height.

(2) Trousers and skirt - The trousers, and skirt for .the

Technical .Service Blouse are of matching shades and material with the coat. The design and cut of the trousers and shirt are same as prescribed for the Dress White. There is however, a .30 cm black stripping of black shade along the outer seams of the trousers and the skirt of the Technical Service Uniform.

(3) Shirt - The shirt for the Technical Service Blouse is

of the same' design and material as "prescribed for the Dress White but shade is off white.

(4) Headgear - Pershing cap for male personnel and

black felt cap for female personnel. However, for foreign traveling purposes and other special occasions as ,prescribed; the oversea cap is the standard headgear for mare and female personnel

(5) Tie - The tie for female, personnel is black satin crescent neckband with 5.1 cm width attached under the front collar of the shirt. The tie for male personnel is black satin and plain woven. It is a 4 hand tie without decoration and when worn, should hang naturally from the neck collar down to the waist. It is secured to the shirt with an AFP regulation cravat clasp.

(6) Footwear - The mates use the tow quarter black

dress shoes. For females, the pump shoes is of tapered heel not more than 7.62 cm in height in black shade, light gloss leather and skin tone nylon hgosiery.

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(7) Accoutrements:

(a) Metal rank insignia fastened on shoulder strap

(b) AFP coat of arms (c) Awards and decorations (d) Service and specialty badges (e) Flight badge (f) Nameplate (g) Highest military schooling badge

d. Bush Coat - Same as prescribed by higher headquarters except that the color is dark gray and that female officers wear the skirt with 2.54 cm black cloth piping at the sides and overlapping slit is prescribed.

(1) Footwear- the males use the low quarter black

dress shoes. For females, the pump shoes is of tapered heel not more than 7.62 and not less than 5.1 cm in height in black shade, light gloss leather and skin tone nylon hosiery.

(2) Accoutrements:

(a) Metal rank insignias on the shoulder strap (b) Awards and decorations (c) Service and specialty badge (d) Flight badge (e) Nameplate (f) Highest military schooling badge

2. Casual Dress Uniforms

a. General Office Uniform (GOU) - is the standard military uniform for general office work and day-to-day duties and activities. It is worn only with the basic accoutrements and without the display of decorations and honorary badges on the shirt It is worn on occasions and functions of casual nature. It consists of a 2-piece ensemble made of an off- white short sleeves polyester and dark gray tropical wool long pants skirt.

1) Trousers - a full-cut straight banging, cuffless and

without pleats. It has 0.31 cm black stripping along outer seams. The bottom front of the trouser legs rests on top of the shoes with a slight break in the creases. The back of the trousers legs extends approximately 27 cm longer than the bottom front.

2) Skirt - The skirt is knee-length which fits snugly but

not tightly around the waist and the hips. It is one-piece semi-pencil cut with overlapping back slit and the back closed by zipper. There is a .03 cm black stripping along the outer seams of the skirt.

3) Shirt - The male shirt is short sleeve of 55%

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polyester and 45% cotton material and off-white shade. The shirt is of commercial type with standing turndown collar secured in front by six 1.27 cm round transparent 2 holed plastic buttons. It has shoulder straps and two breast pockets with flaps secured by matching plastic buttons. It is tucked-in to the pants when worn.

4) Blouse - The female blouse is of same material

and shade as the shirt. It has a round collar and short sleeves and five (5) rounds off- white plastic buttons to close the front opening. It has shoulder straps secured by matching plastic buttons. It has no pockets, with level bottom and worn under the skirt.

5) Headgear- Overseas cap. Pershing or black felt

cap is used as prescribed. 6) Belt and Buckle - The black web belt is worn along

the waistline over the shirt. The insignia logo for respective Technical Service and Administrative Services should be embossed on the silver buckle front surface.

7) Footwear - The males use the low quarter black dress shoes. For females the shoes are of tapered heel not more than 7.62 cm and not less than 5.1 cm in height, in black shade light gloss leather and skin tone nylon hosiery.

8) Bag - Plain black patent leather bag.

b. Office Maternity Uniform - This is another modification of the office uniform and shall be sworn by female members who are pregnant white on office duty. This is used during maternity period when the use of standard uniforms is deemed inappropriate.

1) Blouse- Off-white polyester 55% and tropical wool

45%. Round collar and short sleeves with horizontal cut both front and back. Front has 2.54 an two way pleats meeting at the center each on both sides and another one at the center of the back. The length is up to the end of the torso.

2) Skirt - Dark gray semi-pencil cut, with 20 cm

overlapping slit at the back. Front upper portion is replaced by a stretchable dark gray cotton doth.

3) Paraphernalia and accessories are the same as

that on the General Office Uniform (Class 81).

c. Cold Weather Uniform - the cold weather uniform is long sleeve version of the General Officer Uniform. It is worn with the prescribed regulations necktie. Cold weather attire is worn in cold areas, particularly when on schooling or assigned in cold-weather countries.

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1) Trousers and skirts - The trousers and skirts are the same as prescribed for the General Office Attire.

2) Shirt - The shirt is long sleeve, with French cuff, off

shade as prescribed for the shirt of the General Office Attire made of 55% polyester and 45% tropical wool. It is of commercial type, trubenized style with standing turn down collar and shoulder strap and secured in front by small transparent p1astic buttons. 1t has 2 breast pockets with flaps and closed by matching plastic buttons. The female personnel wear the same shirt material as that of the male personnel. The shirt is tucked in to the pants or the skirt.

3) Trousers and Skirts- the same as prescribed for

the GOU. 4) Headgear - Oversea cap is the prescribed

headgear, when worn with basic accoutrement while Pershing cap for males and black felt cap for female personnel when worn with complete accoutrements and as prescribed.

5) Tie -The tie for female personnel is black crescent

neckband with 5.1 cm width attached under the front collar of the shirt. The tie for male personnel is black satin and -plain woven. It is a 4- hand tie without decoration and when worn, should hang naturally from the neck collar down to the waist. It is secured to the shirt with an AFP regulation cravat clasp.

6) Belt I buckle - the same as prescribed for the GOU.

7) Footwear -the same prescribed for the GOU

d. Cold Weather Jacket- Black and tailored and patterned using the same materials of the major service jacket. 1t has flat cuffs with 2 snap buttons. .'t is used when assigned in places requiring the use of additional clothing such as during cold weather seasons and while in regions of colder climate. .

3. Functional Dress Uniform

a. Battle Dress Uniform (BDU) - The BDU is the standard combat uniform for both male and female military personnel of the Technical and Administrative Services. It is normally worn for maximum cover and concealment in the hostile environment. It is also worn as a field formation uniform for practiced drills and ceremonies and filed training exercises. It is also the standard uniform in disaster relief, search and rescue Operations and on red alert status. The BDU consists of the following:

1) Trouser - The rip- stop trouser is made of 100% cotton fabric in woodland camouflage' pattern. It is full-cut, straight hanging and cuffless. Aside from the normal seam pockets, and 2 back pockets with flaps, the trouser has also 2 patch pockets secured with flaps below the seam

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pockets. The trouser has belt loops. When worn, the lowest part of the trunks must be secured with a garter on top of the upper edge of the combat boots.

2) Shirt - The shirt is of the same material and

camouflaged pattern as the trousers. It is long-sleeved, single-breasted, with 2 breast patch pockets and 2 bottom patch pockets, all covered with flaps. It has a straight cut bottom sleeve tabs, and side body panels with take-up tabs. It may be worn with rolled-up sleeves during ordinary occasions or unrolled sleeves when situations require protection. The patch of respective Technical Service is sewn on the left upper arm sleeve. The name cloth shall be secured above the right breast pocket.

3) Headgear - The camouflage cap with cloth rank

insignia sewn at the center of the front of the cap is the prescribed headgear for the Battle Dress Attire.

4) Belt and Buckle - The olive drab web belt is worn

along the waistline over the shirt. The respective Technical Service and Administrative service insignia logo shall be embossed on the silver buckle front surface.

5) Footwear - the tropical combat boots with black upper canvass and black woolen socks shall be worn.

b. Flight Duty Uniform- is the standard uniform of Technical Service officers on flying status such as flight surgeon nurse. This uniform is lightweight made of polyamide, sage green in color and is fire resistant. This is worn while engaged in flight duties performing aero- medical evacuation functions and during flight alert days. Flight wings, name and rank will be printed on plain black leather patch and shall be attached above the right breast pocket.

c. Hospital Duty White Uniform (For Nurses) - There is two

(2) types of Duty White Uniform for Nurses: one for male nurses, and the other for female nurses. The Nurses Duty White Uniform is the standard uniform for nurses while on hospital duty. It consists of the following:

1) Shirt - The shirt is of dear white shade, made of 55% polyester and 45% cotton, with quarter length sleeves and open collar. It has one left breast slit pocket and 2 lower patch pockets. The bottom is level, and the shirt is worn outside the trousers.

2) Trousers - The trousers for male nurses is the

same as prescribed for the General Office Uniform. 3) One-piece Dress - One Piece-Dress is prescribed

for female nurses. It is made of 55% polyester and 45% clean white cotton, one-piece material, open from neckline to hem and overlapping towards the left. The upper half of the uniform has shoulder yoke with 5 cm pleats on each side. It is dosed with 3 large white plastic buttons, equally spaced, and

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detachable 5 cm waistband, buttons set 12.5 cm apart. The collar is tailored notched lapel with pointed corners, while the sleeves are short with pointed cuffs and fastened with small white round plastic back to back buttons equally spaced. The slit pockets are set diagonally on both sides of skirts panels.

4) Headgear- White nightingale cap for females. There is no prescribed headgear for male nurses when wearing the uniform.

5) Footwear - Male nurses shall wear the low quarter

black dress shoes and plain black cotton socks. Female nurses shall wear white-laced soft leather shoes, plain rounded toe without perforations or decorations and white nylon hosiery.

4. Athletic Uniform

a. Physical Fitness Uniform

1) General use for athletics as prescribed 2) Occasions for wear- use when engaged in athletic

activities

3) Description:

(a) Shirt- plain white short sleeves with sports collar

(b) Shorts- plain white mid- thigh in length (c) Footwear- white rubber shoes and white

socks

b. Sports Competition Uniform- as prescribed by commanders

5. Uniform Items

a. Headgear - The headgear prescribed for officers are the Pershing Cap, oversea garrison cap and camouflage patrol cap for males; and the black felt cap, oversea garrison cap and the white nightingale cap for females.

1) Pershing Cap - is a black visor-type, the crown in

matching shade and material. It has a braid of open mesh construction chinstrap running on top of the visor and connected to the side, together with the black plastic back strap, by 2 small gilded buttons. The mesh-constructed braid and the gilded buttons are of brass shade. The AFP coat of arms is placed at the front center of the crown. For Pershing cap of field grade officers (Major to 9o10nel), the visor and side strap is adorned with gold shaded laurel bullion.

2) Black Felt cap - is the counterpart of the Pershing

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Cap for female military personnel. It is made of black felt material and rounded crown with rolled sides forming a front brim. The black felt cap of field grade officers (Major to Colonel), the visor is adorned with gold shaded laurel bullion.

3) Gray Oversea! Garrison cap - is made of 55%

polyester and 45% tropical wool in matching service color with the brass AFP Coat of Arms pinned on the left front side and the miniature metal rank on the right front side.

4) Camouflage cap- It shall be the same as that

issued with the Battle Dress Uniform and normally worn when using the said uniform, or as prescribed by the commander.

5) White Nightingale cap- this is secured at the back

by three small white plastic back to back buttons and used when on duty in hospitals.

b. Raincoat- This is made of black waterproof, polyvinyl nylon loose fitting with coat extending to between kneecap and midcalf and the sleeves extending to the base forefinger. It has 6 buttons, double- breasted with matching belt and plastic clip buckle, with button throat closure and shoulder and sleeve strap.

c. Umbrella- It is plain black for all military personnel. For

male military personnel, it is only authorized during rainy days. d. Sweater- It is plain white for hospital duty uniform. e. Handbags - both the clutch bag and shoulder bag are

prescribed for female officers only.

1) Clutch bag -It is plain black leather clutch bag. It measures 25.4 cm long, 14 cm wide and 5.08 cm thick.

2) Shoulder bag - It is plain black made either of

calfskin or kid leather, with fold over flap and a plain fastener. It measures 25.4 cm long, 17.5 cm wide and 6.4 cm thick. It is provided with 2.5 cm width adjustable strap.

f. Name Plate - The standard nameplate on the military uniform is black plastic, laminated, with white letter, block style engraved on the plastic. The tag is 3 inches long, and '% inch wide and % lettering. Only the surname will appear in capital block letters in the nameplate. For hospital duty uniform, the surname on black letters is 1 cm embroidered on white doth measuring 8.3 cm long and 2 cm wide background and is sewn above the right breast pocket.

g. Grade Rank Insignia - For hospital duty uniform, it shall

be embroidered on white cloth background and sewn on the right collar. For

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male HC Officers, rank insignias shall be worn vertically while female NC officers shall wear it horizontally. This is applicable to hospital duty uniform only. For flight nurses, the grade rank insignia shall be sewn on both left and right collar.

h. Nurse Corps Caduceus- For hospital duty uniform, it shall be embroidered on white cloth background and sewn on the left collar.

i. Earrings - The standard material and size of earring to

be worn with all types of female uniforms is made of pearl and must be only 0.6-0.7 cm in diameter. For the evening dress uniform diamond or pearls earrings bigger in diameter but not more than 1 cm can be used.

j. Awards and Decorations - military personnel shall wear

their medals and ribbons as prescribed. k. Protective Equipment and Clothing - military personnel

are authorized to wear protective or reflective items (vest, jackets, armbands, or other occupations health or safety equipment) with the uniform when safety or health consideration makes it appropriate. CONCLUDING PROVISIONS

RECISSION CLAUSE. All AFP directives and policies not in consonance with this letter Directive are hereby rescinded and/or modified accordingly.

EFFECTIVITY: This letter-Directive is effective upon publication.

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RECORD OF CHANGES

Identification of change or Correction and Reg. No. (if

any)

Date Entered

By Whom entered (Signature, Rank, Grade, Name or Rate, Name of

Command)

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RECOMMENDATION FOR CHANGES

_____________________________________ ________________________________

_________________________ (Originating Agency)

________________ (Date) SUBJECT: Recommendation for Changes TO: Commanding Officer

Doctrine Center, TRADOC Fort Bonifacio, Makati City The following recommendation is submitted for improvement of _____________________________________________________________

(Short Title)

________________________________ __________________________ (Long Title) page ________________________________ __________________________

Article Para. No. Line Sentence ________________________________ Figure No. Comment: Recommendation:

_____________________________ (Signature of CO)

R E S T R I C T E D

R E S T R I C T E D