Managed healthcare and the home healthcare nurse in the 1990s: selected legal implications.
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Biomedical subjects
Publications and source records attributed to N J Brent.
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This case study about a patient labeled "noncompliant" illustrates a common scenario that home care nurses face in everyday practice. The frustration a nurse experiences when attempting to help a patient who rejects assistance is common and demoralizing and is discussed professionally in this study. A nurse attorney, a nurse manager, and a nurse ethicist respond to the author's case to give insight on the many ways in which this case can be viewed.
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For those nurse executives and managers with an innovative flair and a desire for increased personal and professional autonomy and flexibility, becoming an entrepreneur holds promise of potential financial and personal rewards. The freedom associated with flexible hours and job setting enables many nurses to balance work, family, or school commitments. Along with these rewards come the legal responsibilities of owning and managing a business--something many nurse entrepreneurs believe is well worth the investment.
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At first, consideration of intellectual property law may seem a remote concern. However, CNEs have developed and led the advent of innovative work redesigns, unique measurement instruments, patient care documentation tools, and other administrative research and teaching originations. Consider intellectual property ownership and the rights to use or reproduce that "property" as soon as possible to avoid misunderstandings and potential infringements.
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Effective human resource management practices with an increasingly diverse work force must include consideration of relevant employment law. But leading organizations will venture beyond simply avoiding discriminatory practices. Managing staff differences that emerge from cultural diversity begins with awareness, moves toward sensitivity, evolves into understanding, and concludes with respect.
A sound, integrated risk-management program in home health care can significantly reduce the potential for inclusion in lawsuits. Focusing on two clinical patient care situations (the pregnant woman receiving home uterine activity monitoring and the female patient with acquired immune deficiency syndrome), this article presents the components of risk management and their practical implications for the delivery of nursing care in the home.
Nurse managers have a pivotal role in intervening in situations of substance abuse among employees. This article addresses ethical and legal dimensions of chemical impairment from the perspective of the nurse manager. The value of a rehabilitative rather than a punitive approach to the chemically impaired nurse is emphasized. Ethics of care and relevant legal considerations, including the Americans With Disabilities Act, are explored through case analysis. Covenantal relationships offer a framework for examining the responsibilities of the nurse manager with respect to the community, employer, the actual or allegedly chemically impaired nurse, and one's self.
Over the past 3 years, the massive unionizing campaigns forecasted have not materialized. Even so, the parameters of the AHA case are still being established. For example, the NLRB currently is attempting to determine if nurse practitioners still should be placed in a bargaining unit with registered nurses or physicians. Until this and other issues are resolved more clearly, nurse administrators must play a key role in balancing the professional concerns of patient care quality and staff satisfaction with the reality of current economics and healthcare reform. Clearly, unionization cannot be ignored in attempting to achieve that balance.
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