Patient Care Issues Management Issues and Employment Issues
Patient Care Issues Management Issues and Employment Issues
Patient Care Issues Management Issues and Employment Issues
Nursing covers a wide range of disciplines and health-care issues that are
always changing and at the forefront of what guides this career path. Issues
such as health-care reform, nursing shortages, low salaries and ethics are
some of the issues being faced. With nursing being an integral part of
hospitals, nursing homes, home health agencies and colleges, the discipline
has to keep current of changing policies and be prepared to address
whatever may arise.
Nursing Shortage
The nursing shortage is a major issue facing the biggest licensed profession
in the health-care system. This shortage will affect health care more each
day, as it appears not much is being done to stop it. Many emergency rooms
have longer wait times due to less nursing staff, and hospital floors are
feeling the effects as well. This is affecting patient care because the number
of patients to one nurse is increasing, therefore decreasing the quality of
care. This shortage is being felt in hospitals, nursing homes and home-
health agencies. Nursing has been lobbying for patients by seeking
legislation to help with the nursing shortage and with funding for nursing
schools.
Health-Care Reform
Nurses have always been involved with health-care reform as advocates for
patients. The American Nursing Association (ANA) has been working to have
the voice of nurses heard. Nurses are in support of a public plan, so
Americans who are underinsured or uninsured will have access to
affordable, quality health insurance. The ANA has taken the stand that
health care is not a privilege but a right. It is lobbying for a reduction in cost
and an end to high out-of-pocket costs for services, as well as ending
discrimination pertaining to pre-existing conditions
A nurse who is caring for a patient has a legal duty to ensure that the
patient receives safe and competent care.
This duty requires that the nurse maintain an appropriate standard of
care and also obtain an appropriate care from other professionals
when that is necessary.
If the outcome is unfavourable, the nurse can be found to have
breached a duty to the patient.
In a recent study, the “failure to rescue” individuals experiencing life
threatening complications was linked to a lower number of RNs.
Additionally, the nurse has a responsibility to critically examine the
medical orders that are written for a patient.
INFORMED CONSENT:
Every person has the right to either agree or to refuse health care
treatment.
Because of this right, doctors need consent from patients before they
can treat them.
Consent may be expressed in words or implied by the patient’s
actions.
For certain procedures consent form is required as the part of the
consent process.
Consent should be documented on the chart.
Obtain consent for the treatment is the responsibility of the medical
provider. (eg : physician, dentist, nurse practitioner )
Information should be shared with client include a description of
procedures, any alternatives for treatment, the risk involved in the
procedures and the problem results.
A person can only give valid consent if they are competent or have
capacity. Capacity means the person is able to understand the
information that is necessary to make a decision about the proposed
treatment.
If someone is not capable of giving consent, they need a substitute
decision maker to act on their behalf.
ADVANCE DIRECTIVES:
LIVING WILL:
Eg: most commonly they declare that if “I am terminally ill and not
expect to recover ,” then “I want this care and do not want this care given”
FRAUD:
Fraud is deliberate deception for the purpose of personal gain and is
usually prosecuted as a crime.
One example would be trying to obtain a better position by giving
incorrect information about the patient to a physician.
This may be prosecuted as a crime, because the nurse placing the
patient in a danger.
Courts tend to be more harsh in decisions regarding fraud than in
cases involving simple malpractices, because fraud represent a
deliberate attempt to mislead others for your own gain and could
result in harm to those assigned to your care.
FALSE IMPRISONMENT:
B. MANAGEMENT ISSUES
Nurses working in doctors' offices and hospitals have a difficult job caring
for patients and meeting the needs of both coworkers and superiors within
the institution. Nurse Managers who work in the medical professional also
have a complex and challenging role. It is a considerable challenge to meet
the needs of the organization, the needs of patients, and the needs of the
nurse employees
Turn over means the rate at which the employees leave a company
and are replaced by other peoples or staffs.
Maintaining adequate staffing levels is a major issue in nursing
management.
Representatives working in nurse management and leadership are
often faced with the responsibility of controlling attrition rates.
Turnover in the nursing industry can be more difficult to control.
Nurses faced with long work hours for relatively little pay have few
motivations to remain in one position and often seek employment
opportunities at competing hospitals and neighboring clinics.
Since recruiting and training new nurses takes time and money, the
nursing leaders are charged with consistently working to keep
turnover levels low and to maintain current staff levels in an effort to
provide a minimum of quality patient care.
FUNDING:
Funding concerns are relevant to all areas of nursing leadership and
management.
Lack of funding is an issue for many nurse managers who seek to
provide sufficient compensation to existing nurses as well as to recruit
new nursing professionals for hire.
An underfunded institution cannot attract and provide for the right
professionals.
Funding inadequacies can also become a harm to the level of training
provided to medical staff, in addition to the needs for medical
equipment and supplies.
When the medical institution's quality of staff and training standards
must be lowered because of budgetary concerns, the overall level of
patient care is unavoidably reduced.
WORK LOAD:
Individual nurse manager workload and overall medical workload are
issues in leadership.
The medical profession is one that never sleeps and has an almost
constant need for qualified professionals both in hiring and
scheduling.
Not only do nurse professionals work long hours and many days per
week, but nurse managers and leaders are also faced with an ever-
increasing workload.
Dealing with patient concerns, providing training and support to
nurses, and acting as a liaison between doctors, nurses and medical
administration members can be taxing and stressful.
Many nurses are unwilling to enter into the nurse management field
because of the added stress and responsibility.
ETHICS
Effects of reform, shortages, ethics and salaries are issues that keep
nurses constantly thinking, growing and changing. Nursing
instructors make far less money than nurses in the clinical setting.
They also make less than other educators in different fields. In order
for nursing to succeed, there needs to be qualified candidates
educated, but with these low salaries nurses are not flocking to this
career path. Without these types of nurses being adequately filled
then qualified candidates will not have the opportunity to be taught.
These salaries need to be increased, and colleges and universities
need to see the value in these instructors.
As nursing faculty we need to answer the question and analyze the present
situation whether or not we are on the road to relevant, which means the
validation of curriculum or judgemental process in which an attempts is to
be made to ascribe a degree of worth or value to a curriculum in the context
of professional education and preparation of participants for their
professional role
Walker describes five types of validation
Academic validation
Professional validation
Economic validation
Institutional validation
Performance validation
This deals with the thinking and aspiration for future. Faculty must think
whether the educational program what is designed will help to meet the
expectations of individuals, families and communities in accordance far with
the developed countries or not.
Nurse educators must be able to analyze and think critically that we are
preparing the students with the adequate skills to perform their expected
roles in all the three domains of professional tasks such as practical,
communication and intellectual skills according to the institutional goals
and educational objectives. The three types of skills to be achieved:-
The faculty must think the ways by which the curriculum can be developed
to which is relevant to meet the needs of the country.
COLLABORATION ISSUES
The nursing profession is faced with increasingly complex health care issues
driven by technological and medical advancements an ageing population,
increased numbers of people living with chronic disease, and spiraling costs.
Collaborative partnerships between educational institutions and service
agencies have been viewed as one way to provide research which ensures an
evolving health care system with comprehensive and coordinated services
that are evidence- based, cost – effective and improve health care outcomes.
These partnerships also ensure the continuing development of the
professional expertise necessary to meet these challenges
EMPLOYMENT ISSUES
UNEMPLOYMENT:
-Unemployment rates for women are higher than those for men.
MINIMUM WAGE:
AGE DISCRIMINATION:
Older workers are more likely to have been with a company for a
longer period of time.
They are therefore likely to be in a senior position, or at the very
least have had many years to receive raises in the salary.
This increases the damage for past and future lost wages and
benefits.
Employee law suit against employers are increasing yearly because
the age discrimination occurs frequently.
INCREASED
EXPECTATIONS
FATIGUE
WORK-PLACE VIOLENCE
SEXUAL HARASSMENT
The Courts have time and again reiterated that employees enjoy security of
tenure of employment. The maxim "easy to hire difficult to fire" is a truism
even in the case of probationers. No employer having hired a person at
considerable cost and having exposed the person to training, formal or
otherwise, will want to terminate the person. However, when an employee
has an attitude problem or whose work performance is not up to the
expectations he cannot be terminated by the employer simply by invoking
the termination clause in the employment contract. The employer has to
follow certain rules and procedures and only at the end of it can he
terminate the services of a non-performing employee. Even then, there are
no iron clad assurances that the termination will not be challenged by the
employee at the Industrial Court. How does an employer ensure that he
minimizes the risk of being challenged in Court over a termination of
employment due to unsatisfactory work performance? This talk will attempt
to take you out of the labyrinth.
It has long been held that the employer has the inherent right to
discipline his workers. Should misconduct be committed, the
employer after a proper inquiry has been instituted can impose a
suitable punishment, including dismissal if the offence committed was
of a serious nature. The decision on the type of punishment to be
imposed is under all circumstances a subjective one. The Courts will
interfere if, among others, the action taken by the management was
perverse, baseless or unnecessarily harsh or was not just or fair.
There have been occasions where employers have imposed the
punishment of dismissal for misconduct which they have assessed as
serious but these cases have been reviewed by the Industrial Court
and the decision of the employer substituted. Given that imposition of
punishment is a subjective matter, what factors or criteria should an
employer apply in determining appropriate punishment for
misconduct committed in employment. This talk, among others, will
examine some of the issues to be taken into account
This issue need indepth study of merits and demerits as well as its
feasibility before it could come on the surface.
Overall, legal and ethical issues are occurs in every fields. Some
issues recur frequently in nursing practice. It is wise for the nurse to
understand these particular issues as they related to individual
practice. The nurse and other health care team members have the
rights and responsibilities to prevent and overcome the issues which
occurs in their field.
ASSIGNMENT:
THEORY APPLICATION:
Students gained
Students having
Teaching about the knowledge
inadequate
patient care issues, regarding patient
knowledge
management issues, care issues,
regarding patient
employment issues & management issues,
care issues,
medico-legal issues employment issues
management
using power point & medico-legal
issues,
presentation issues
employment
issues & medico-
legal issues.
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BIBLIOGRAPHY
Book reference:
11.Janice Rider Ellis (2004), “Nursing in today’s world”, 8th ed; Lippincott
Williams Wilkins, page no: 289-302
Net reference:
*www.google.com
*www.scribd.com