FINAL BLUEPRINT 2138 FALL 2022
1. 1.Professionalism
Explain the relationship of nursing Unions
organizations and unions to the Types
concept of professionalism. 2. Unions are used to help achieve a positive change in the workplace for the workers who have paid dues.
Describe the potential positive and National Organizations: occur with state & regional chapters
negative impact of nursing State Organizations: regulatory responsibility by the statute for education & practice
organizations and unions as related to Workplace Organizations: various nursing units, departments within hospital
nursing as a profession.
Unions: no relationship exists unless nurses obtain majority vote of members of their work group (excluding management), once majority vote has been
obtained, union can represent them after they have paid their dues, no relationship exists if management is attentive & responsive to nursing employee
concerns & complaints, if not & union is voted in, the nurses become responsible to 2 authorities: have to answer to all of the union rules & still have to
adhere to hospitals administration policies within their workplace.
Open shop: nurses are not required to join or financially support a union as a condition of being hired
Closed shop: union security agreement where employer only agrees to hire union members
----> promise to achieve positive changes in the workplace, income, benefits, & working conditions←---
ANA: a union that represents nurses, a collective bargaining agent, has a dual role: organization for nurses & state association as collective bargaining
agent. “Participates in establishing, maintaining & improving health care environments & conditions of employment conducive to the provision of quality
health care & consistent with the values of the profession through individual & collective action”
Collective bargaining: legal process in which representatives of organized employees negotiate with employers about matters such as wages, hours, &
working conditions.
2. Describe the potential positive and 2. Professionalism: labor standards focus
negative impact of nursing Reasons nurses join unions: To increase the power of the individual, To increase their input into organizational decision making, To eliminate
organizations and unions as related to discrimination and favoritism, Because of a social need to be accepted, Because they are required to do so as part of employment (closed shop)
nursing as a profession. Because they believe it will improve patient outcomes and quality of care
Reasons nurses don’t join unions: A belief that unions promote the welfare state and oppose the American system of free enterprise, A need to
demonstrate individualism and promote social status, A belief that professionals should not unionize, An identification with management’s viewpoint,
Fear of employer reprisal, Fear of lost income associated with a strike or walkout
Positive impact of unions: continuity of care, continual professional growth, active within professional organizations, safe patient environment
Negative impact of unions: unsafe patient care, negative patient outcomes, violation of practice standards, suspension or loss of license, consequences
within criminal or civil laws
Taft Hartley Law: “right to work” laws that prohibited employees from being required to join a union as a condition of employment
Least likely to be a standard
3.Describe the potential positive and 3.Professionalism: Moral Development
negative impact of the Role
Transition to RN Accountability, if there is a med error tell supervisor then MD, be more active in ANA, get involved in professional organizations.
Ethical nurses-moral development= ability to behave ethically, must be careful to cultivate it
4. Identify major legislation that has 4.Professionalism: Legislation
increased the opportunity for nurses Interest based bargaining or shared governance: introduced to help solve problems between labor & management, nurses are given a voice in the policy &
to align with nursing organizations procedures of the institution--->participate in management
and unions. Agency for Healthcare Quality & Research: lead national effort to combat medical errors focusing on extended work hours, mandatory overtime, &
regulation of nurse staffing levels, resulted in “keeping the patient safe”
Bill of Rights for RNs
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which new graduate nurse
participation is encouraged Professional values: altruism (well being of others), autonomy, human dignity (protects privacy), integrity (honesty), social justice (non discrimination),
(Commitment to Profession) (to “… Autonomy, nonmaleficence, beneficence, justice, fidelity, Ethical conduct
incorporate the …values of the Non maleficence: taking care of issues, Beneficent: to do good, try to prevent harm
profession while maintaining
New nurse-list of violations: Nurse Practice Act
accountability and self-awareness”)
given the reality of differences
between a nursing organization and
unions.
1. Review the concept of Ethical & 6.Ethics & Legal: Whistleblowing
Legal Practice (including definition, Whistle-blowing is a warning from a present or past member of an organization to the public concerning a serious wrongdoing or danger created or
antecedents, and attributes) masked by the organization. Whistleblowing laws are intended to prevent nurses from being retaliated against job, suspension, detention, harassment, or
discharge.
Do not blow the whistle for personal gain
Have adequate documentation to establish wrongdoing
Consult with your state nurses association or legal counsel if possible before taking action to determine how best to document your concerns.
You are not protected from retaliation by your employer until you blow the whistle
Blowing the whistle means that you report your concern to the national and/or state agency responsible for regulation of the organization for which you
work or, in the case of criminal activity, to law enforcement agencies as well.
Private groups such as The Joint Commission or the National Committee for Quality Assurance do not confer protection, YOU MUST REPORT TO
STATE OR NATIONAL REGULATOR.
Put your complaint in writing
Keep documentation & interactions objective, keep copies of documentation for personal file
Remain calm, do not lose your temper
Report unsafe medical devices
MD Document he rounded/ assessed patient but did not nurse whistleblower: protected by legislation
2. Analyze conditions which place a 7.Ethics & Legal: Safe harbor
patient at risk in situations involving Action must be made before accepting assignment, request must be in writing.
Whistle Blowing, Safe Harbor, A nurse can use a quick request form if he/she does not have time to complete comprehensive request
Obligation to Report, Risk The nurse's supervisor should complete section 2 by end of the work period
Management, and Advance Must document why assignment is unsafe & send by the end of the work period & before leaving the practice setting KEEP A COPY for your personal
Directives.
file
Safe Harbor can also be used when the nurse advocates for the patient & challenges a physician's order.
***if you accept assignment you are held to same competences as other nurses
When can you claim safe harbor: before you take the assignment
3. Identify when moral distress 8.Ethics & Legal: Obligation to report
(negative consequence) is developing Nurses are frequently the first members of the public to detect abuse. Abuse includes a physical, verbal, sexual, or emotional attack; neglect; and
or has developed in relation to abandonment. Targets of abuse include infants, children, and adult men and women of all ages. Abusers are men and women of all ages, races,
Whistle Blowing, Safe Harbor, socioeconomic groups, and religious backgrounds. Nurses are obligated both ethically and legally to report abuse. In many states, the failure to report
Obligation to Report, Risk actual or suspected abuse is a crime in itself. Nurses are protected by law against suits from alleged abusers if they file a report of suspected abuse in good
Management, and Advance
faith that turns out to be erroneous.
Directives.
- You are obligated to report if patient/co worker is chemically impaired, stealing, lying, cheating
Report through chain of command first then if needed, report to outside agency such state nurses associations and agencies. Under state Nurse Practice
Acts, and the state and federal examples below, perioperative nurses also have a legal obligation to report conduct that’s incompetent, unethical, and
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***Report to supervisor first
Reporting an incident to the peer review committee satisfies the nurse’s duty to report
child says her uncle does not clean her that way-mother tells her to be quiet= report
to nursing supervisor & authorities
report impaired nurse to =TPAP first
3. Identify when moral distress 9.Ethics & Legal: Obligation to report. SAME as # 8
(negative consequence) is developing
or has developed in relation to
Whistle Blowing, Safe Harbor,
Obligation to Report, Risk
Management, and Advance
Directives.
4. Describe the ethical-legal 10.Ethics & Legal: Risk Management strategies
parameters and requirements for Incident Reports: also called variance or occurrence report is used to document occurrence of anything out of the ordinary that results in, or has the
nursing practice related to Whistle potential to result in harm to the patient, employee, or visitor. It is used as a means for quality improvement & not for disciplinary action, it is a means of
Blowing, Safe Harbor, Obligation to identifying risks.
Report, Risk Management, and The one who is responsible or witness of event is the one to fill out the form
Advance Directives and interventions
Risk Management: provides a structured approach to identifying, assessing, & managing risks; process by which vulnerabilities are identified & changes
for each.
are made to minimize consequences of adverse patient outcomes & liability. Proactive (anticipating & preventing) & reactive (investigations).
Nurse does NOT need to document that an incident report was filed
Do NOT state fault, do not elaborate or confess--->facts & objective documentation only
risk management strategies= ID practices that need to be changed to EBP,
participate in high risk clinical practices, inform nurse manager when staff is not
adequate
4. Describe the ethical-legal 11.Ethics & Legal: advance directives
parameters and requirements for Living will, allows people to state in advance what their choices would be for health care should certain circumstances develop. The nurse puts the
nursing practice related to Whistle advance directives in the patients chart, can sign as witness, but family can overturn if comes down to it.
Blowing, Safe Harbor, Obligation to advance directive in another state= document is legal in that state (Michigan)
Report, Risk Management, and
Advance Directives and interventions
for each.
1. Explain the concept of Health 12.Health Policy: nursing regulation
Policy (including definition,
antecedents, and attributes). Government oversight provided by each state; health policy is a form of public policy, goal directed decision making about health that is the result of an
authorized, public decision making process. It focuses on how organizations function within context of socioeconomic political environment at every
level (state, federal, national). Developing health policy is similar to nursing process (problem solving, decision making framework). Nurses are at the
frontline in a position to influence healthcare policy issues both at the bedside & decision making levels.
Policy Advocating: professional organizations promote the development of the profession. Professional nursing organization functions: define standards
of practice & professional behaviors, support nursing research, & participate in policy development at all levels.
Advocate: join organization, participate in functions, be involved
NCLEX: regulated by the state
2. Analyze processes by which health 13.Health Policy: NPA purpose. Health Policy PPT slide 9.
policies are developed, implemented, Practice of nursing is regulated at the state level through a Nurse Practice Act (NPA). An NPA is a series of state statues that define the scope of practice, standards for
evaluated, changed and maintained. education programs, licensure requirements & grounds for disciplinary actions. Each state’s NPA is enforced and administered by a state board of nursing (BON). Each
BON oversees the administration of a licensure examination that measures the competencies needed to perform safely and effectively as a newly licensed, entry level
