FIELDS OF

NURSING
Ariel M. Ortuoste, RN
CLASSIFICATION OF FIELDS
OF NURSING IN GENERAL
1. Hospital of institutional nursing
2. Public health nursing or CHN
3. Private duty or special duty nursing
4. Industrial or occupational health nursing
5. Nursing education
6. Military nursing
7. School nursing
8. Clinic nursing
9. Independent nursing practice
INSTITUTIONAL NURSING
Nursing in hospitals and related health
facilities such as extended care facilities,
nursing homes, and neighborhood clinics,
comprises all of the basic components of
comprehensive patient care and family
health.
The educational qualification for
beginning practitioners is a Bachelor of
Science in Nursing degree. The nurse as a
member of the health care team,
participates in all phases of patient care
of the acutely ill, the convalescing and
the ambulatory patient.
ADVANTAGES OF STAFF
NURSING IN HOSPITALS
There is always a supervisor whom one can
consult if problems exist.
Nurses are uploaded with new trends in
medicine and in the nursing care of patients.
They undergo rotation to different units and
have a chance to determine their special area
of choice before they are assigned permanently
in one area such as Medicine, Pediatrics,
Surgery, ICU-CCU, Obstetrics, Operating Room,
Delivery Room, etc.
They have 8 hours/day and a 40 hour
week duty which provide for two days of
rest away from duty. They have
provisions for sick leaves, holidays and
vacations with pay according to
personnel policies of the institution.
They have the chance to get promoted
to higher positions if they are qualified.
Salary increases are given periodically
according to merit system thereby
increasing their initiative and best
efforts.
They are considered an important
member of the health team in providing
care for the patients.
More staff development programs are
available in hospitals.
DISADVANTAGES OF STAFF
NURSING IN HOSPITAL
There is a great possibility of
understaffing which may require nurses
to put in overtime work and sacrifice
some of their plans.
Because of the bulk of work, some staff
nurses do not find time to improve their
skills through continuing education
programs. Or, if the hospitals are far-
flung, no continuing education programs
are provided.
Administrative problems and overwork
may tend to dissatisfy the staff nurse.
PUBLIC HEALTH NURSING OR
COMMUNITY HEALTH
NURSING
The National Health Program of the
Philippines gives as much emphasis on
the promotion of health and prevention
of diseases rather than care of the sick.
ADVANTAGES OF PUBLIC
HEALTH NURSING
The focus of nursing care is only on
family and community health rather
than on an individual basis. Here, the
nurse will be able to see the total picture
of family and community health.
It gives the nurse a better perspective of
the health conditions of the community
and the health programs conceived and
implemented by the government, and
to appreciate the nurses role in nation
building.
It maximizes efforts to improvise where
there are no sufficient facilities, supplies
and equipment.
It enable the nurse to utilize various
community resources and maximize
coordination with other members of the
health team.

Focus of care is more on educational and
preventive aspects. Thus, nurses have the
privilege of contributing to the program
for healthy citizenry especially among
the rural poor.
Individuals, families and communities
are motivated to assume responsibility
for their own health care.
DISADVANTAGES OF PUBLIC
HEALTH NURSING
Cases found in public health nursing are
limited mostly to chronic and/or
communicable diseases.
There are more hazards in public health
than in hospital nursing, such as
exposure to elements ( inclement
weather, heat of sun, rain), dog or snake
bites, accidents, etc.
There are no fixed hours of work. The
nurse may be called upon any time of
the day or night.
Some claim that public health nursing is
not as exciting nor as glamorous as
hospital work.
Facilities for care of the sick are limited
so that practice or skills may be limited.
The public health nurse may not be
immediately aware of changes or trends
in the fields of medicine or nursing.
Public health nursing is not a place for
introverts. A nurse has to be outgoing to
meet people.
There is no immediate supervisor to
consult in case of emergency.
NURSES IN IN-SERVICE
EDUCATION PROGRAMS
In-service education programs have
been in existence for many years both in
hospitals and public health agencies. This
is one way of improving service in these
agencies. Many tertiary hospitals and
public health agencies have nursing staff
in charge of staff development training
and research.
Nurses in this field need:
Skills in nursing practice, therefore they
must have experience of at least two
years in basic nursing practice.
Understanding of skills in teaching,
supervision, and consultation;
Understanding of the relationship of
these persons to the process of
administration and research.
Understanding of the broad problems
and desirable practices in patient-care
planning;
Understanding of and skill in the use of
problem-solving approach to resolve
everyday problems in the practice of
nursing and in-service education;
Understanding of self and others
involved in in-service education within
the various agencies in nursing; and
Ability to plan and implement programs
for different kinds of nursing personnel.
PRIVATE DUTY NURSING
Nurses in private practice are expected
to be expert clinicians as well as expert
generalist nursing. They use the title
Private Duty Nurse, Private Duty
Practitioner, Special Duty Nurse or
Private Duty Nurse Specialist.
Gategories:
1. GENERAL PRIVATE DUTY NURSE- the
general private duty nurse has the
capabilities of providing basic nursing
care to any type of patient, among
which are:
1. Assessment of physical conditions and
interpretation of the significance of his/her
findings as basis for planning the nursing
care;
2. Identification of emotional and social
factors and relating these signs and
symptoms observed;
3. Application of scientific principles in the
performance of nursing techniques.
4. Working with patients family so that they
gain understanding of his/her illness and
cooperate towards promoting early
recovery of the patient.
5. Utilization of laboratory and diagnostic tests in
promoting progress of care and enhancing his/her
own usefulness as a health teacher and counselor;
6. Knowledge and recognition of pharmacological
effects of drugs and medications, their implications
for nursing actions as needed;
7. Interpretations of Doctors orders concerning
medicines and treatments and communicating the
same effectively to the patient and carrying them
out promptly and accurately with understanding of
cause and effects.
2. PRIVATE DUTY NURSE SPECIALIST- in
addition to the foregoing abilities
expected of the general nurse
practitioner and as a result of his/her
specialized preparation, a private duty
nurse specialist also demonstrates the
following competencies:
Skill in handling, operating, and
monitoring other complicated devices;
Skill in interpreting data gathered from
ECG, EEG, laboratory diagnostic results
and vital signs;
Skill in observing signs and symptoms
and favorable or untoward significance
in the progress of patient care; and
Promptness and adeptness in instituting
appropriate nursing measures.
Qualifications of a private
nurse practitioner
Be a registered nurse in the Philippines
Have the following documents:
Professional tax receipt (PTR
Professional regulation Commission Card
(PRC) and
Residence certificate
Have at least 2 years of bedside nursing
experience as a professional nurse in a
general hospital immediately prior to
application.

Be acceptable to the Director of Nursing
Service as suitable for orientation to do
private duty nursing;
Be a full time private duty nurse;
Preferably have undergone a Critical
Care Nursing Course; and
Be a certified I.V. nurse therapist by the
ANSAP
requirements
To undergo orientation in the hospital as
conducted by the Nursing Service office;
To have the complete paraphernalia
(BP apparatus, pen light, bandage
scissors, tripen, etc)
To wear full white nurses uniform
To have medical certificate from a
certified medical center or laboratory
with CXR result, CBC, urine and stool
exam.
To acquire, for succeeding years,
certificate of 3 seminars or continuing
education programs attended;
To give 2 character references
To show certification as an I.V. Therapist
by the ANSAP.