Michael S Mitchell, Clifford M Koen, Stephen M Crow
{"title":"Your workers may be contingent, but your liability for them is certain: part I: employment status and Fair Labor Standards Act issues.","authors":"Michael S Mitchell, Clifford M Koen, Stephen M Crow","doi":"10.1097/NHL.0b013e3181f390cf","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181f390cf","url":null,"abstract":"<p><p>Hiring contingent workers can significantly help health care employers reduce labor costs while maintaining the staff required for quality patient care. However, a number of federal laws create legal landmines that await the unsuspecting employer. The purpose of this article was to familiarize health care employers with some of the rapidly evolving legal issues that surround the use of contingent workers.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 3","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181f390cf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29207965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transparency in research and its effect on the perception of research integrity.","authors":"Marcia M Boumil, Harris Berman","doi":"10.1097/NHL.0b013e3181ee2781","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181ee2781","url":null,"abstract":"<p><p>Pharmaceutical companies routinely engage faculty from academic medical centers to participate in biomedical research. Faculty contribute expertise and research subjects and often receive considerable compensation for their efforts. Because the role of the researcher can be compromised by financial conflicts of interest, disclosure of such relationships is routinely required. The effect of such disclosure is not entirely clear, however, and studies have yielded inconsistent results on how those receiving financial disclosures perceive the integrity of the research. Reviewing the literature, we conclude there is little consensus on how the disclosure of a financial relationship with an industry sponsor affects confidence in the research. We also conclude that is it unclear whether the new Patient Protection and Affordable Care Act will substantially alter the landscape.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 3","pages":"64-8"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181ee2781","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29207962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Johnston, Phylavanh Phanhtharath, Brenda S Jackson
{"title":"The bullying aspect of workplace violence in nursing.","authors":"Michelle Johnston, Phylavanh Phanhtharath, Brenda S Jackson","doi":"10.1097/NHL.0b013e3181e6bd19","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181e6bd19","url":null,"abstract":"<p><p>Workplace violence is becoming an issue that all organizations must be aware of. In healthcare organizations, these behaviors, especially that of bullying, are detrimental and affect staff, patients, and outcomes. Healthcare organizations that do not address this issue and instill measures to prevent it will soon see the effects that bullying and other forms of workplace violence can create: those of toxic work environments. Because bullying and other forms of workplace violence have become so prevalent, organizations such as The Joint Commission have addressed the need for healthcare organizations to address the issue. This article examines bullying, the most common type of workplace violence, and nursing, the profession where bullying most often occurs. Theories about why it exists and suggestions on how to prevent it and maintain a healthy workplace will be discussed.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 2","pages":"36-42"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181e6bd19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29019563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucia D Wocial, Maureen Hancock, Patricia D Bledsoe, Amy R Chamness, Paul R Helft
{"title":"An evaluation of unit-based ethics conversations.","authors":"Lucia D Wocial, Maureen Hancock, Patricia D Bledsoe, Amy R Chamness, Paul R Helft","doi":"10.1097/NHL.0b013e3181de18a2","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181de18a2","url":null,"abstract":"<p><p>Unit-based ethics conversations (UBECs) provide nurses with an opportunity for meaningful conversation about the ethical issues they face in routine clinical practice. The goal of the program is to increase participants' abilities and confidence in dealing with ethically challenging situations. This article reviews results from a formal evaluation of UBECs at one organization. The results of this evaluation suggest the UBEC program provides a transformational ethics experience for nurses.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 2","pages":"48-54; quiz 55-6"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181de18a2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29019565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does good documentation equate to good nursing care?","authors":"Marcia Sue DeWolf Bosek, Marcia Ellen Ring","doi":"10.1097/NHL.0b013e3181e05ee7","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181e05ee7","url":null,"abstract":"<p><p>Good documentation does not necessarily equate to good care. This article explores the potential underpinnings of poor documentation from an ethical decision-making lens. Nursing standards of care related to documentation are reviewed. The internal and external constraints of moral distress are considered, as is moral residue. Finally, the roles of the nurse administrator as well as specific remedial and restorative measures are suggested.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 2","pages":"43-7"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181e05ee7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29019564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"NCSBN focus: 2009 Update on the National Council of State Boards of Nursing's regulatory model for transitioning new nurses to practice.","authors":"Nancy Spector, Marcy Echternacht","doi":"10.1097/NHL.0b013e3181d294c1","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181d294c1","url":null,"abstract":"","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 1","pages":"12-4"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181d294c1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28746644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"JONA's Healthcare Law, Ethics, & Regulation. Letter from the editor.","authors":"Rebecca F Cady","doi":"10.1097/NHL.0b013e3181d2b584","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181d2b584","url":null,"abstract":"","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181d2b584","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28746643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David J Ramsey, Mary Lou Schmidt, Lisa Anderson-Shaw
{"title":"Online ethics discussion forum facilitates medical center clinical ethics case reviews.","authors":"David J Ramsey, Mary Lou Schmidt, Lisa Anderson-Shaw","doi":"10.1097/NHL.0b013e3181d2a5a2","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181d2a5a2","url":null,"abstract":"<p><p>Clinical ethics consultants are increasingly called upon to give counsel in the clinical arena on issues including but not limited to withdrawal or withholding of specific medical treatments, assisting minors and mentally impaired patients with care decisions, working with difficult patients and families, identifying appropriate surrogate decision makers, and executing advance directives and end-of-life decisions. Often, the consultant may need to convene the ethics committee members to review and provide feedback for a given case. This process may be difficult to schedule in a timely way because of member's clinical and other work-related obligations. To this end, the University of Illinois Medical Center in Chicago has set up a unique Web board to facilitate ongoing case discussions via a secured, password-protected ethics committee online forum. This allows for real-time review by all ethics committee members. We will explain our online process as well as discuss our clinical case experiences.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181d2a5a2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28746646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Americans with Disabilities Act-related considerations when an alcoholic nurse is your employee: when is a nurse legally considered a \"direct threat\" to patient safety?","authors":"Juliet Battard Menendez","doi":"10.1097/NHL.0b013e3181d20125","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181d20125","url":null,"abstract":"<p><p>When contemplating the legal and ethical issues surrounding employment of an alcoholic nurse, nursing administrators are challenged with recognizing and upholding the Americans With Disabilities Act (ADA)-related civil rights of their employees while ensuring the quality of care provided by the practitioners in their facility. The \"direct-threat\" exception to disability accommodations relieves employers from making accommodations for a disability if those accommodations would necessitate lowering patient care quality standards. According to the ADA's direct-threat exception, a healthcare facility may legally terminate a nurse with the disability of alcoholism if that practitioner poses a threat to the safety of its patients. This article provides an informative overview of alcoholism as a disability in the context of nursing. A nurse administrator could use the information provided to objectively and competently make a determination of direct threat. The focus is on the importance of making an objective and unbiased assessment when determining if an alcoholic nurse meets the direct-threat\" criteria that eliminates the requirement for making reasonable accommodations for a disabled employee. General ADA guidelines are provided, but the assessment must be individualized based on the patient care setting, the requirements of the position, and the nurse's present ability to safely perform the essential job functions.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"12 1","pages":"21-4; quiz 25-6"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181d20125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28746648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Respecting patient autonomy versus protecting the patient's health: a dilemma for healthcare providers.","authors":"James M Badger, Rosalind Ekman Ladd, Paul Adler","doi":"10.1097/NHL.0b013e3181c1b542","DOIUrl":"https://doi.org/10.1097/NHL.0b013e3181c1b542","url":null,"abstract":"<p><p>A 74-year-old man with multiple chronic medical problems was hospitalized for respiratory distress. He experienced recurrent aspiration and required frequent suctioning and endotracheal intubation on several occasions. The patient was deemed competent and steadfastly refused feeding tube placement. The patient demanded that he be allowed to eat a normal diet despite being told that it could lead to his death. The patient wanted to go home, but there was no one there to care for him. Additionally, neither a nursing home nor hospice would accept him in his present condition. The case is especially interesting because of the symbolic value of food and the plight of the patient who has no alternative to hospitalization. The hospital staff experienced considerable stress at having to care for him. They were uncertain whether their obligation was to respect his autonomy and continue to provide food or to protect his health by avoiding aspiration, pneumonia, and possible death by denying him food. This ethical dilemma posed by the professionals' duty to do what is in the patient's best interest versus the patient's right to decide treatment serves as the focus for this case study. Ethical, legal, and healthcare practitioners' considerations are explored. The case study concludes with specific recommendations for treatment.</p>","PeriodicalId":80291,"journal":{"name":"JONA'S healthcare law, ethics and regulation","volume":"11 4","pages":"120-4; quiz 125-6"},"PeriodicalIF":0.0,"publicationDate":"2009-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NHL.0b013e3181c1b542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28526397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}