Week 7 Discussion Board

Chapter 11

Employee Rights

and

Responsibilities

Learning Objectives

• Describe and understand the rights of employees.

• Describe the responsibilities of employees in the workplace.

• Discuss what professionals can do to improve professional relationships.

Employment at Will

• The employer or employee may terminate employment at any time: – Unless there is a contract in place that

specifies the terms and duration of employment.

– Public policy considerations. – Implied covenant of good faith and fair

dealing.

An at will prerogative without limits could be suffered only in an anarchy, and there not for long, it certainly cannot be suffered in a society such as ours without weakening the bond of counter balancing rights and obligations that holds such societies together.

—Sides v. Duke

Public Policy Exceptions Prohibiting Termination

• Public policy exception to the employment- at-will doctrine provides that employees may not be terminated for reasons contrary to public policy.

• Public policy originates with legislative enactments.

Freedom from Discrimination

– Disability − Religion – Age − Sex – Race − National origin – Creed − Pregnancy – Color − Filing OSHA complaints

Equal Pay Act of 1964

• Prohibits wage disparities based on sex. • Prohibits discrimination in payment of wages for

women and men performing substantially equal work in same establishment.

• Wages may be unequal as long as they are based on factors other than sex, for example: – Formalized seniority system. – System that objectively measures earnings by

quantity or quality of production.

Refuse to Participate in Care

• Refusal to participate in elective abortion upheld. • Refusal to participate in therapeutic abortion is

insubordinate. • Some pharmacists refuse to fill birth control

prescriptions.

Caregiver’s Right (1 of 2)

The nurse in the operating suite refuses to participate in an elective abortion.

• Discuss how an organization might fairly address this dilemma.

Caregiver’s Right (2 of 2)

• Legal issues – Employee’s right to religious freedom – Organization’s responsibility to provide care

• Ethical issues – Nonmaleficience – Professional codes of ethics

Questioning Patient Care

• Public policy clearly mandates an obligation to serve the best interests of patients.

• Persistence to get the proper treatment for the patient is an absolute duty.

• Case: Paving Her Way to Heaven

Suggesting Change of Physician (1 of 3)

Physician failed to return the nurse’s calls. Because of the patient’s deteriorating condition, the family contacted the nurse. After the nurse advised the patient’s family as to her concerns, a member of the patient’s family asked her what they should do. The nurse advised that she would reconsider their “choice of physicians.” The nurse was terminated because she had advised the patient’s family to consider changing physicians.

Suggesting Change of Physician (2 of 3)

• What action might the hospital might take? • What should the jury do? Discuss your

answer. • Discuss the legal issues in this case. • Discuss the ethical issues in this case. • What was the court’s decision?

Suggesting Change of Physician (3 of 3)

The North Carolina Court of Appeals held that the nurse stated a claim for wrongful discharge in violation of public policy. The nurse’s termination for fulfilling her responsibilities as a practicing nurse violated state public policy and was a factual question for jury determination.

One’s dignity may be assaulted, vandalized, and cruelly mocked, but it cannot be taken away unless it is surrendered.

—Author unknown

Freedom from Disruptive Behavior

• Includes freedom from verbal outbursts and physical threats.

• Prevent disruptive events from occurring. • Deal with events in real time to prevent staff or

patient harm. • Initiate post-event review, actions, and follow-up.

Freedom from Bullying

• Bullying includes: – Abusive conduct – Threats – Humiliating behavior – Name calling – Personal insults

Impact of Bullying

• Lowers morale • Reduces productivity • Increases absenteeism • Increases turnover • Negatively affects patient safety

Freedom from Sexual Harassment

• Employees have a right to be free from sexual harassment.

• Sexual harassment includes: – Requests for a sexual favors. – Sexual advances, condition employment. – Unreasonably interfering with employee's

work. – Creating intimidating or offensive working

environment.

Treatment with Dignity and Respect

• Right to be treated with dignity and respect fairly and consistently.

• Respond to employee complaints and concerns.

Freedom from Intimidation

• Those in power often abuse power through threats, abuse, intimidation, and retaliatory discharge.

• Employees who become targets of a vindictive supervisor often have difficulty in proving a bad-faith motive.

• Some states (e.g., Connecticut, Maine, Michigan, and Montana) have enacted legislation that protects employees from terminations found to be arbitrary and capricious.

Privacy and Confidentiality

• Health status privacy • Fine line to protecting one’s privacy • Reality Checks

– Your Mail Has Been Intercepted – Trust Is Pivotal to Success

Family Medical Leave • Employees have a right to take a medical leave

of absence under the Family and Medical Leave Act (FMLA).

• 12 work weeks of unpaid leave during any 12- month period for: – Birth of a child – Placement of adopted foster child – Care of immediate family member – Serious health condition

Whistleblowing

• Someone “who, believing that the public interest overrides the interest of the organization he serves, publicly blows the whistle if the organization is involved in corrupt, illegal, fraudulent, or harmful activity.”

• Organizations often describe their whistleblower policy in their compliance manuals.

• Demotion, intimidation, reassignment, reduction in work hours, or constructive discharge are prohibited by law.

Employee Responsibilities (1 of 4)

• Know your patient. • Educate and encourage patients to ask

questions. • Be compassionate. • Comply with state and federal regulations. • Comply with hospital policy. • Comply with assigned duties. • Honor and respect patients’ rights.

Employee Responsibilities (2 of 4)

• Maintain confidentiality. – Compliance officer and confidentiality.

• Adhere to safe practices. – Follow hand hygiene guidelines.

• Admit to mistakes. • Adhere to professional standards.

Employee Responsibilities (3 of 4)

• Maintain professional relationships. – Shoot the Consultant – Sexual harassment

• Nurse’s relationship with patient • Physician’s inappropriate house call • Avoid relationships with a patient’s spouse

Employee Responsibilities (4 of 4)

• Report unethical behavior. • Protect patients from harm. • Report patient abuse. • Stand as a patient advocate. • Work with team spirit. • Maintain professional competencies. • Encourage teamwork.

Professional Competencies

• Have current understanding of one’s area of specialization and practice.

• Continuation education. • Current in knowledge and skills.

Helpful Advice (1 of 4)

• Do not say: – The physician is not here when he or she is. – The physician will soon be here when he or

she has already left the building. – This will not hurt, when you know it will. – You are busy when you are not.

Helpful Advice (2 of 4)

• Take responsibility for caring and communicating.

• Include the patient in the decision-making process.

• Take the time to explain to patients the risks, the benefits, and alternatives to each course of treatment.

• Listen to what the patient is saying without interruption.

Helpful Advice (3 of 4)

• Show respect and sensitivity to the patient’s needs.

• Do not make fun of a patient’s decision-making capacity.

• Avoid demeaning and criticizing a patient’s wishes because of his or her frail condition.

Helpful Advice (4 of 4)

• The feelings of the family and those of patient may differ.

• Continue to improve competencies. • Remember that patients can be challenging. • Patient handbooks and employee training. • Patients also have rights and responsibilities.

Caregiver’s Pledge

I will be compassionate.

I will not neglect my duties and responsibilities.

I will read instructions and follow protocols.

I will seek verification of questionable orders.

I will report concerns for patient safety (e.g., staffing concerns).

I will not assume responsibilities beyond my capabilities.

I will call for help when a patient’s medical needs suddenly change.

I will continuously improve my skills and participate in continuing education opportunities.

Review Questions

1. Describe the rights of employees.

2. Describe under what circumstances an employee has a right to refuse to participate in a patient’s procedure.

3. Does a nurse have a right to question the care being rendered to a patient? Explain your answer.

4. Is the employment-at-will concept appropriate in today’s society?

5. Describe the responsibilities of employees as described in this chapter.

6. Describe what caregivers can do to build a spirit of teamwork and improve the quality of patient care.

Review Questions