Attention to this aspect of workplace improvement is not as well developed as the social aspect, especially in nursing. However, with the increase in technology in health care, we may see more attention to this area of work life. The use of lighting, colors, and music in improving the workplace environ- ment is increasing. Computer workstations designed to promote efficiency in the client care unit are becoming commonplace. Modi- fications to various elements of the physical environment, such as the floors, chairs, desks, beds, and workstations, can decrease the inci- dence of back and upper extremity injuries.
Relocation of supplies and substations closer to client rooms to reduce steps, easier visual and auditory scanning of clients from the nurses’ station, better light and ventilation, a unified information system, and reduced need for client transport are all possible with changes in the physical environment.
Healthcare pollution is a more recent iden- tified problem. The CDC states that less than 2% of all hospital waste must be incinerated, yet most hospitals claim they incinerate 75–100%. Dioxin emissions, mercury, and battery waste are often not disposed of prop- erly in the hospital environment. Disinfec- tants, chemicals, waste anesthesia gases, and laser plume that floats in the air are other sources of pollution exposure for nurses.
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Do...
Recognize diversity Value diversity
Develop informal supports Ensure fairness
Make these principles an integral part of your individual philosophy
Don’t...
Pretend everyone is alike Expect everyone to con-
form to the prevailing culture
Seek a quick solution Develop different stan-
dards of performance Expect one workshop to
solve the problem
TABLE 11–4 Do’s and Don’ts for
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Managing Diversity
Nurses have a responsibility to be aware of these potential problems and identify areas in the hospital at risk. Rethinking product choic- es, such as avoiding the use of PVC or mer- cury products, location of collection sites for battery and mercury waste, and mandatory education for employees is a start toward a more pollution-free environment. (Slattery, 1998, p 12).
CONCLUSION
Workplace safety is an area of increasing con- cern. Staff members have a right to be informed of any potential risks in the work- place. Employers have a responsibility to pro- vide adequate equipment and supplies to protect employees as well as programs and
policies to inform employees about minimiz- ing risks to the extent possible. Issues of workplace violence, sexual harassment, and impaired workers should be addressed to pro- tect both employees and patients.
A social environment that promotes profes- sional growth and creativity and a physical environment that offers comfort and maxi- mum work efficiency should be considered in improving the quality of work life. Cultural awareness, respect for the diversity of others, and increased contact between groups should be the goals of the workforce for the next century.
Many waking hours are spent in the work- place. It can offer a climate of companionship, professional growth, and excitement. You can be part of the solution if you remain aware of workplace issues.
156 ❖ Essentials of Nursing Leadership and Management
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Image/Text rights unavailable
R E F E R E N C E S
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C R I T I C A L T H I N K I N G E X E R C I S E
You have been hired as a new registered nurse on a busy pediatric unit in a large metropolitan hospital. The hospital provides services for a culturally diverse pop- ulation including African American, Asian, and Hispanic people. Family mem- bers often attempt alternative healing practices specific to their culture and bring special foods from home to entice the sick child to eat. One of the more experi- enced nurses said to you, “We need to discourage these people from fooling with all this hocus-pocus. We are trying to get their sick kid well in the time allowed under their managed care plans, and all this medicine-man stuff is only making the kid sick longer. Besides, all this stuff stinks up the rooms and brings in bugs.’’
You have observed how important these healing rituals and foods are to the clients and families and believe that both the families and the children have bene- fited from this nontraditional approach to healing.
1. What are your feelings about nontraditional healing methods?
2. How should you respond to the experienced nurse?
3. How can you be a client advocate without alienating your coworkers?
4. What could you do to assist your coworkers in becoming more culturally sensitive to their clients and families?
5. How can healthcare facilities incorporate both Western and nontraditional medicine? Should they do this? Why or why not?
S T U D Y Q U E S T I O N S
1. Why is it important for nurses to understand the major federal laws enacted to protect the individual in the workplace?
2. What actions can nurses take if they believe that OSHA guidelines were not being followed in the workplace?
3. What are nurses’ responsibilities in dealing with transmission of blood-borne pathogens in the workplace?
4. Describe the difference between a supportive and a nonsupportive social envi- ronment in the workplace.
5. How can you, as a new nurse, raise awareness related to cultural diversity issues in the workplace?
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158 ❖ Essentials of Nursing Leadership and Management
C H A P T E R 1 2
Professional Issues
C H A P T E R 1 3
Questions of Values and Ethics
C H A P T E R 1 4
Your Nursing Career
C H A P T E R 1 5
Historic Leaders in Nursing
C H A P T E R 1 6
Nursing Today
C H A P T E R 1 7
Looking to the Future
Professional Issues
U N I T I I I
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Nursing Practice and the Law
O U T L I N E General Principles Meaning of Law Sources of Law Types of Laws Criminal Law Civil Law
Other Laws Relevant to Nursing Practice Good Samaritan Laws
Confidentiality Slander and Libel False Imprisonment Assault and Battery Standards of Practice
Use of Standards in Nursing Negligence Malpractice Actions
Patient’s Bill of Rights Informed Consent Staying Out of Court Prevention
Common Actions Leading to Malpractice Suits If a Problem Arises
Professional Liability Insurance End-of-Life Decisions and the Law Do Not Resuscitate (DNR) Orders
Advance Directives Nursing Implications Conclusion
O B J E C T I V E S
After reading this chapter, the student should be able to:
• Identify three major sources of laws.
• Explain the differences between various types of laws.
• Differentiate between negligence and malpractice.
• Explain the difference between an intentional and an unintentional tort.
• Explain how standards of care are used in determining negligence and malpractice.
• Explain the difference between internal standards and external standards.
• Discuss advance directives and how they pertain to clients’ rights.
C H A P T E R 1 2
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161
The courtroom was cold and sterile. Scanning her surroundings with nervous eyes, Marie decided she knew how Alice must have felt when the Queen of Hearts screamed for her head. The image of the White Rabbit running through the woods, looking at his watch, yelling, “I’m late! I’m late!’’ flashed before her eyes. For a few moments, she indulged herself in thoughts of being able to turn back the clock and rewrite the past. The future certainly looked grim at that moment.
The calling of her name broke her reverie. Mr.
Jefferson, the attorney for the plaintiff, wanted her undivided attention regarding the fateful day when she injected a client with 40 mEq of potassium chloride in error. That day, the client died following cardiac arrest because Marie failed to check the appropriate dosage and route for the medication. She had administered 40 mEq of potassium chloride by IV push. Her 15 years of nursing experience meant little to the court. Because she had not followed hospi- tal protocol and had violated an important stan- dard of practice, Marie stood alone. She was being sued for malpractice.
As client advocates, nurses have a responsibil- ity to deliver safe care to their clients. This expectation requires that nurses have profes- sional knowledge at their expected level of practice and be proficient in technological skills. A working knowledge of the legal sys- tem, client rights, and behaviors that may result in lawsuits helps nurses to act as client advocates. As long as nurses practice nursing according to the established standards of care, they will be able to avoid the kind of day in court that Marie experienced.