Policy and governing concepts
- The State adopts a policy to protect and improve the nursing profession through measures that promote relevant nursing education, humane working conditions, better career prospects, and a dignified existence for nurses (Section 2).
- The State guarantees quality basic health services through an adequate nursing personnel system throughout the country (Section 2).
- “Nursing practice” covers three (3) areas: nursing education, nursing services, and community health nursing (Section 3[d]).
- The IRR recognizes Official organizations and professional structures that interact with the Board and Commission, including an Accredited Professional Organization (APO) (Section 3[j]).
Key definitions and recognized bodies
- “New Nursing Act” means Republic Act No. 9173 (Section 3[a]).
- “Commission” means the Professional Regulation Commission (PRC) created under Section 3 of Republic Act No. 9173 (Section 3[b]).
- “Board” means the Professional Regulatory Board of Nursing created under Section 3, Article III of Republic Act No. 9173 (Section 3[c]).
- “Professional Nurse” means a person whose name and registration/professional license number appear in the Commission’s registry book and computerized database as legally authorized to practice nursing (Section 3[e]).
- “Practicing Professional Nurse” covers persons engaged in nursing practice or performing nursing acts/activities, regularly or occasionally, including those employed in government or private entities whose duties require nursing knowledge and application (Section 3[f]).
- “Foreign Professional Nurses” are foreign nationals licensed in their own countries and authorized by existing Philippine laws to practice in the Philippines, subject to the rules on reciprocity/special permits and referenced limits under Republic Act No. 8981 and Republic Act No. 9173 (Section 3[g]).
- “Accredited Professional Organization (APO)” means the Philippine Nurses Association (PNA), Inc. or any professional organization of nurses accredited by the Commission (Section 3[j]).
Board composition, qualifications, and powers
- The Board consists of a Chairperson and six (6) members, representing nursing education, nursing service, and community health nursing (Section 4).
- The Board operates under the administrative supervision and control of the Commission, and the Commission keeps custody of Board records, including applications for examinations and administrative/investigative cases (Section 4[a]).
- The Commission designates the Secretary of the Board and provides secretariat and support services needed for implementation (Section 4[b]).
- The President appoints the Chairperson and six members upon recommendation of the Commission, strictly from nominees submitted by the APO to fill vacancies (Section 5).
- The appointment process requires:
- the Commission to notify the APO and request at least three (3) qualified nominees per vacancy before the last year of a member’s term (Section 5[a]);
- the APO to submit three (3) nominees per vacancy not later than three months before the vacancy occurs (Section 5[b]);
- the Commission to rank nominees and submit two (2) nominees per vacancy to the President not later than two (2) months before the vacancy occurs, requesting appointment not later than thirty (30) days before scheduled licensure examinations (Section 5[c]);
- operating procedures to be embodied in a Memorandum of Agreement (MOA) between the Commission and the APO (Section 5[e]);
- reappointment to follow E.O. No. 496 (Section 5[d]).
- Board qualifications at appointment require that the Chairperson and members:
- be natural born citizens and residents of the Philippines;
- be members of good standing of the APO;
- be registered nurses with a master’s degree in nursing, education, or other allied medical profession (and the Chairperson and majority of Members must hold a master’s degree in nursing);
- have at least ten (10) years of continuous practice, with the last five (5) years in the Philippines;
- must not have been convicted of any offense involving moral turpitude (Section 6).
- Board term rules provide:
- office is three (3) years and continues until successors are appointed and qualified;
- no Chairperson or Member may be appointed and/or reappointed for more than two (2) terms or a total of six (6) years (Section 7[a]);
- mid-term vacancies cover only the unexpired portion of the predecessor’s term (Section 7[b]);
- the Chairperson and Members must take the proper oath before performing duties (Section 7[c]);
- incumbent members under Republic Act No. 7164 continue for the remainder of their term until replacements are appointed and qualified (Section 7 (incumbent clause)).
- Removal or suspension:
- the President may remove or suspend any member after administrative investigation and opportunity to defend, on grounds of continued neglect of duty or incompetence, irregularities in licensure examinations (commission/toleration), or unprofessional/immoral/dishonorable conduct (Section 8).
- Compensation:
- Board Chairperson and Members receive compensation and allowances comparable to other professional regulatory boards under the Commission (Section 9).
- Conflict/requirements upon appointment:
- the appointee must immediately resign from any teaching position in any nursing/BSN/review program for local nursing board examinations (Section 10[a]);
- must immediately resign from offices/employment in the private sector or government (including GOCCs and their subsidiaries) (Section 10[b]);
- must have no pecuniary interest or administrative supervision over institutions offering BSN (pecuniary interest includes involvement of spouse/children, brothers/sisters, mother/father in conflicting money matters) (Section 10[c]).
- The Board supervises and regulates nursing practice in the Philippines and performs functions including:
- conducting licensure examinations;
- issuing, suspending, or revoking certificates of registration for nursing practice;
- monitoring and enforcing quality standards of nursing practice;
- ensuring quality nursing education by examining facilities of nursing education institutions;
- conducting hearings and investigations on complaints involving unethical/unprofessional conduct and violations, including issuing subpoena ad testificandum and subpoena duces tecum and punishing contempt for obstruction through court application;
- adopting a Code of Ethics and Code of Technical Standards within one (1) year from effectivity of the nursing act, in coordination with the APO;
- recognizing nursing specialty organizations based on jointly developed criteria;
- prescribing, adopting, issuing, and promulgating guidelines, regulations, measures, and decisions necessary for improvement and enforcement, subject to Commission review and approval;
- submitting an annual report to the Commission at the end of each calendar year detailing proceedings, accomplishments, and recommendations (Section 11).
Licensure examinations and registration process
- Applicants for registration and issuance of a certificate of registration/professional identification card must pass a written licensure examination given by the Board in places/dates designated by the Commission, fully compliant with Republic Act No. 8981 (Section 12).
- Admission to the licensure examination requires, at the time of filing:
- Philippine citizenship, or eligibility under a reciprocal premise for citizens/subjects of a country that permits Filipino nurses to practice under substantially the same requirements (Section 13[a]);
- good moral character (Section 13[b]);
- a Bachelor’s Degree in Nursing from an institution meeting recognized standards by the proper government agency (Section 13[c]).
- The Board determines the examination scope considering nursing curriculum objectives, broad areas of nursing, and related disciplines/competencies (Section 14).
- Passing/rating requirements require:
- an examinee must obtain a general average of at least 75% with no subject below 60% (Section 15[a]);
- if the general average is 75% or higher but any subject is below 60%, the examinee must retake only the subjects below 60%; passing the succeeding examination requires at least 75% in the repeated subject(s) (Section 15[b]);
- a removal examination must be taken within two (2) years after the last failed examination (Section 15[c]).
- Successful candidates must take an oath of profession before the Board, a Commission official duly designated, or an authorized government official before commencing nursing practice (Section 16).
- Upon payment of prescribed fees, successful candidates are issued:
- a Certificate of Registration/Professional License bearing full name, serial number, signatures of the Chairperson of the Commission and Members of the Board, and official seals of the Commission and the Board (Section 17[a]);
- a Professional Identification card bearing date of registration, license number, and date of issuance and expiration date, signed by the Chairperson of the Commission (Section 17[b]).
- Applicants pay prescribed examination and registration fees set by the Commission (Section 18).
- Automatic registration:
- nurses whose names appear in the Roster of Registry Book of Nurses are automatically registered as nurses under the Act upon its effectivity (Section 19).
- Reciprocity registration for foreign nurses:
- a foreign nurse is registered without examination and issued a certificate and identification card if (i) registration/licensing requirements in the foreign state are substantially the same as those under the Act, and (ii) that state grants similar privileges to registered Filipino nurses (Section 20).
- Special/Temporary Permit for foreign nurses:
- the Board may issue a Special/Temporary Permit subject to prior Commission approval and payment of prescribed fees, effective only for the duration of the project/medical mission/employment contract, to foreign licensed nurses who are (a) internationally well-known specialists/outstanding experts, (b) in medical missions with free services in a hospital/center/clinic, or (c) exchange professors at schools/colleges in specialty nursing (Section 21).
- Grounds for non-registration and non-issuance:
- the Board does not register or issue certificates/identification cards or special/temporary permits to persons convicted by final judgment of any criminal offense involving moral turpitude, guilty of immoral or dishonorable conduct, or declared by the court of unsound mind (Section 22).
- the Board must furnish a written statement of reasons for its action, incorporated into Board records (Section 22).
- Revocation/suspension and cancellation grounds:
- the Board may revoke/suspend certificates and cancel permits for causes including causes under Section 22 of the nursing act, unprofessional/unethical conduct, gross incompetence/serious ignorance, malpractice or negligence, fraud/deceit/false statements in obtaining credentials, violations of Republic Act No. 9173, IRR, Code of Ethics, Code of Technical Standards, Board/Commission policies, or special permit conditions, and practicing during suspension (Section 23).
- suspension of a certificate may not exceed four (4) years (Section 23).
- Re-issuance and replacement of revoked certificates:
- the Board may issue another copy after proper application and payment for equity/justice and subject to Board rules only when (a) after expiration of a maximum four (4) years from revocation date, (b) when the revocation cause has disappeared or been cured/corrected, or (c) for replacement of lost/destroyed/mutilated certificates/licenses (Section 24).
Nursing education and competency requirements
- Nursing education programs must provide a sound general and professional foundation for nursing practice and must be aligned with learning outcomes based on national and universal nursing core competencies (Section 25).
- Learning experiences must strictly adhere to specific curriculum requirements promulgated by the Commission on Higher Education’s policies and standards of nursing education (Section 25).
- Return-to-practice requirements for inactive nurses:
- nurses who have not actively practiced for five (5) consecutive years and return to practice must undergo one (1) month didactic training and three (3) months practicum (Section 26).
- the Board accredit hospitals to conduct the training, and accredited hospitals must develop training programs based on Board guidelines (Section 26).
- Faculty qualifications:
- a faculty member teaching professional courses must be a registered nurse, have at least one (1) year clinical practice in a specialization field, be a member of good standing of the APO, and hold a master’s degree in nursing/education or other allied medical and health sciences conferred by a government-recognized college/university (Section 27).
- a Dean must, in addition, hold a master’s degree in nursing and have at least five (5) years of teaching and supervising experience in nursing education programs (Section 27).
Scope of nursing practice and nurse duties
- A person is deemed to be practicing nursing when the person initiates and performs nursing services, alone or with others, to individuals, families, and communities in any health care setting, including nursing care during conception through old age (Section 28).
- Independent practitioners are primarily responsible for health promotion and illness prevention, while members of the health team collaborate for curative, preventive, and rehabilitative care and for restoration of health, alleviation of suffering, and—when recovery is not possible—toward a peaceful death (Section 28).
- Nursing care includes, among others, utilization of the nursing process, traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings, and administration of written prescriptions for treatment/therapies and oral, topical, and parenteral medications (Section 28[duties]).
- Nursing practice duties include executing internal examination during labor in the absence of antenatal bleeding and delivery, and providing special training for perineal laceration suturing according to established protocol (Section 28[duties]).
- Additional nursing duties include establishing linkages with community resources and coordinating with the health team, providing health education, teaching/ guiding/supervising students and administering nursing services in varied settings, undertaking consultation services, and engaging in activities requiring nursing decision-making and continuing education/training/research including development of advanced nursing practice (Section 28[duties]).
- Nursing students performing nursing functions under direct supervision of qualified faculty are not covered by the enumerated nurse duties (Section 28 (student clause)).
- While practicing in all settings, nurses must:
- observe the Code of Ethics and Code of Technical Standards for nurses;
- uphold standards for safe nursing practice;
- maintain competence through continual learning via continuing professional education submitted to and approved by the Board (Section 28 [required duties]).
Nursing service administration and appointments
- Nursing Service Administrator qualifications are mandatory:
- for supervisory/managerial positions: registered nurse; at least two (2) years general nursing service administration experience; a Bachelor of Science in Nursing degree with at least nine (9) units in management and administration courses at the graduate level; and good standing in the APO (Section 29[1]);
- for Chief Nurse or Director of Nursing: all foregoing requirements plus at least five (5) years in a supervisory/managerial nursing position and a master’s degree in nursing (Section 29[2]);
- for Chief Nurse for Primary Hospitals: registered nurse; at least two (2) years general nursing service administration experience; and a Bachelor of Science in Nursing degree with at least nine (9) units in graduate-level management and administration course (Section 29[3]).
- Appointment priorities:
- Chief Nurse in public health agencies receives priority for those with a master’s degree in public health/community health nursing (Section 30[1]);
- Chief Nurse in military hospitals receives priority for those who completed a master’s degree in nursing and the completion of the General Staff Course (GSC) (Section 30[2]).
- Persons already occupying such positions before the Act’s effectivity have five (5) years to comply with the requirements to qualify (Section 30 (transitory clause)).
Health human resource development measures
- The Board must initiate, undertake, and conduct studies on health human resource production, utilization, and development in coordination with the APO and appropriate government or private agencies (Section 31).
- The Board must formulate and develop a comprehensive nursing specialty program, in coordination with the APO, recognized specialty organizations, and the DOH, to upgrade specialty nurse clinicians’ skills (including, but not limited to, critical care, oncology, renal, and other areas determined by the Board) (Section 32).
- The program requires Board resolution subject to Commission approval and becomes effective only after complete or full publication in the Official Gazette or in a newspaper of general circulation, whichever is earlier (Section 32).
- Beneficiaries of the specialty program receive a certificate of completion and must serve in any Philippine hospital for at least two (2) years of continuous service (Section 32).
- Salary floor in public health institutions:
- minimum base pay of nurses in public health institutions shall not be lower than the 1st step or hiring rate for Salary Grade 15 under Republic Act No. 6758 (Section 33).
- for nurses working in local government units, salary adjustments follow Section 10 of Republic Act No. 6758 (Section 33).
- implementation must follow rules and regulations prescribed in a DBM circular (Section 33).
- Comprehensive nursing specialty program funding:
- the annual financial requirement to train at least ten percent (10%) of the nursing staff of participating government hospitals is chargeable against the income of the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation, which share the cost equally, release funds to the DOH subject to usual accounting and auditing procedures (Section 34).
- the DOH sets criteria for program availment (Section 34).
- Incentives and benefits limitation and nurse-patient ratio:
- incentives/benefits under the nursing act are limited to non-cash benefits, including free hospital care for nurses and their dependents, scholarship grants, and other similar non-cash benefits (Section 35).
- the Board, DOH, DBM, in coordination with other concerned agencies, association of hospitals, and the APO must formulate and establish the incentives system and implementing rules and regulations (Section 35).
- government and private hospitals must maintain the standard nurse-patient ratio set by the DOH (Section 35).
Prohibited acts and criminal penalties
- Practicing nursing without proper credentialing or authority is punishable by:
- a fine of not less than PHP 50,000 nor more than PHP 100,000, or imprisonment of not less than one (1) year nor more than six (6) years, or both—imposed for conduct including practicing in the Philippines without a certificate of registration/professional identification card/special temporary permit or without exemption from examination; using another person’s credentials; using invalid credentials (suspended/revoked/expired/cancelled permit); giving false evidence to obtain credentials; falsely posing/advertising as a registered and licensed nurse; appending B.S.N.R.N. or similar after a name without having that degree/registration; or abetting illegal practice by an unqualified person (Section 36[1]).
- Conduct by persons or chief executive officers of juridical entities:
- engaging in in-service educational programs or conducting review classes for both local and foreign examinations without permit/clearance from the Board and the Commission is punishable by the same fine and imprisonment ranges or both (Section 36[2]).
- Violations by persons or employers:
- violating the minimum base pay of nurses and the incentives/benefits that should be accorded them as specified in Sections 32 and 34 of Republic Act No. 9173, as implemented by Sections 33 and 35 of this IRR is punishable by the same fine and imprisonment ranges or both (Section 36[3]).
- Violating any provision of Republic Act No. 9173, as implemented by this IRR, is punishable by the same fine and imprisonment ranges or both (Section 36[4]).
- Where the court imposes imprisonment or fine, it follows the statutory range in Section 36 at the court’s discretion (“or both”).
Enforcement, cooperation, funding, and final rules
- The Commission and the Board have the primary duty to effectively implement Republic Act No. 9173 and the IRR (Section 37).
- Law enforcement assistance:
- duly authorized law enforcement agencies and officers at national, provincial, city, or municipal levels must assist upon call/request of the Commission or Board in enforcing Republic Act No. 9173 and this IRR and in prosecuting violators (Section 38).
- the Commission and the Board may enter into a Memorandum of Agreement with law enforcement and subject government offices to define procedures for assistance requests/calls (Section 38).
- Appropriations:
- initial implementation costs for Republic Act No. 9173 are charged against the current year’s appropriations of the Commission under the General Appropriations Act (GAA), and subsequent needs are included in the Commission’s program in succeeding GAAs, with Board and Commission issuing necessary implementing rules in coordination with the APO, DOH, DBM, and other concerned agencies (Section 39).
- Separability:
- invalidity or unconstitutionality of any provision or its application does not affect the remainder of the IRR or application to other persons/circumstances (Section 40).
- Supersession of conflicting issuances:
- Board or Commission issuances, including resolutions and circulars/orders, or parts that conflict with the IRR are superseded or modified accordingly (Section 41).