Legal Issues Affecting the Healthcare Work place - Research Paper Example

Running head: Legal issues in healthcare Legal Issues Affecting the Healthcare Work place Legal Issues Affecting the Healthcare Work place Introduction The healthcare workplace is one of the most demanding, labor intensive, and stressful workplaces. Health professionals often have to carry out their functions under emergency conditions with barely seconds to spare before life-threatening conditions set in. More often than not, in carrying out health functions, legal issues emerge. These issues may involve the inadequate conduct of responsibilities, the failure to carry out functions, or the inappropriate conduct of responsibilities. The minimum legal requirements in the conduct of functions for any health professional is laid out by the basic federal, state, and local mandates, as well as the legal and ethical mandates as set forth by the health profession. Issues in the workplace may also involve the failure of the health managers to support and respect the rights of their workers. In this case, these issues interfere with the safe and appropriate conduct of health services by the health workers. This paper shall now discuss the different legal issues which affect the healthcare workplace. Possible solutions to these issues shall also be discussed for purposes of establishing appropriate adjustments for the healthcare practice and the protection of patients’, as well as workers’, rights. Discussion Workplace violence One of the major legal issues in the healthcare workplace involves workplace violence. Workplace violence can take on various forms from bullying, aggression, abuse, harassment, horizontal violence and mobbing (Leonard, Norman, and Spring, 2009). Workplace violence or aggression can constitute intentional behavior with the ultimate goal of harming or injuring another person physically or psychologically (Leonard, Norman, and Spring, 2009). Bullying can include a series of incidents when overt or covert aggression can be inflicted on a person through spreading of rumors, withholding data, blocking promotion, or inflicting psychological abuse through exclusion (Leonard, Norman, and Spring, 2009). Horizontal violence is also a form of bullying, but it involves non-physical acts of aggression between employees of similar hierarchical positions. It includes: criticizing, insulting, undermining, and bickering (Leonard, Norman, and Spring, 2009). Mobbing involves negative actions of a group directed towards one employee. Parties involved may be those of higher positions abusing those in lower positions. Workplace abuse may either be physical through shoving, pushing, and kicking, or it may also be verbal through berating or threatening; it may be active or passive; and it may also be directly or indirectly carried out (Leonard, Norman, and Spring, 2009). In healthcare, studies and reviews indicate that these workers are about 16 times more likely to suffer workplace violence as compared to other employees. Moreover, nurses who are often at the frontline of health services are subjected to abuse from family members of patients. These nurses are unavoidably exposed to these dangers because they are exposed to patients who have issues related to substance abuse, domestic violence, HIV/AIDS, mental health problems, and other social issues (Leonard, Norman, and Spring, 2009). In effect, the patient’s health issues and unfavorable conditions when they face nurses create dangerous scenarios for nurses. Based on studies and surveys, about 71% of nurses experience various forms of workplace violence. A study of nurses working in ERs and mental health facilities revealed that about 55% experienced physical assault, 12% experienced verbal abuse, and 10% were physically threatened (Leonard, Norman, and Spring, 2009). These acts were most often carried out by patients and some acts were carried out by the patient’s families; the rest were perpetrated by fellow health care professionals (Leonard, Norman, and Spring, 2009). Forty two percent faced sexual aggression and 39% experience physical aggression and most of these acts were perpetrated by physicians, followed by fellow nurses, and then by patients (Leonard, Norman, and Spring, 2009). Workplace violence is a major legal issue in the healthcare workplace because it can compromise the physical and the psychological well-being of health workers; moreover, it can also compromise their delivery of quality health services. Victims of threats can also be seriously emotionally impacted (Beech and Leather, 2006). Such impact can have major consequences which can amount to occupational health issues rather than clinical issues in the workplace. In estimating the costs and impact of workplace violence, intangible costs rank high on the list of costs. Such intangible costs translate to loss of morale, issues with recruitment and retention, higher fear of staff, and post traumatic stress (Beech and Leather, 2006). Financial costs can be seen in the form of sickness absence, premature ill health, and early retirement. In the social sense, workplace violence also amount to a significant losses. In England and Wales, studies reveal that about 3.3 million working hours are lost with each year due to workplace violence (Beech and Leather, 2006). Annual direct costs associated with workplace violence has actually amounted to about 69 million, without taking into account staff replacement costs and compensation claims (Beech and Leather, 2006). In the international scene, workplace violence has been seen to cause issues in recruitment and in retention of staff. Death and injuries have been seen as consequences of workplace violence; moreover, incidents of physical assault and physical injuries have been known to undermine the staff’s psychological well-being (Beech and Leather, 2006). In general, health workers experiencing workplace violence manifested with general poor health, depression, isolation, concentration issues, reduced self-confidence, and impaired responsiveness. Furthermore, workplace violence has been known to jeopardize, not just the staff member’s health, but the organization’s health as well. In the healthcare sector, this is a dangerous phenomenon because the quality of healthcare delivery can be compromised and can generally endanger the patient’s health. Occupational safety issues One of the occupational safety legal issues which are seen in the healthcare workplace refer to the risks associated with the health worker’s exposure to communicable diseases. These communicable diseases pose health risks to health workers with the possible transmission of infectious agents: either through bloodborne or airborne means. The common and most dangerous health risks are the following diseases: HIV/AIDS, hepatitis virus A, B, and C, and tuberculosis (Pozgar, 2007). By the very nature of the health worker’s jobs, they are often in close contact with their patients. In handling their patient’s blood, saliva, urine, feces, and other fluids, they are already exposing themselves to the risk of infection. The healthcare administrators actually have the responsibility of ensuring that their workers are adequately equipped with the necessary personal protective equipment (gloves, mask, turbans, etc) in order to prevent infection (WHO, 2011). However, despite this available equipment, health workers are still exposed to these health risks; in fact, some are actually infected in the workplace with the abovementioned communicable diseases. It is the utmost responsibility of management to protect their workers and to provide them with adequate and sufficient PPEs in order to protect them from health risks (MFL Occupational Health Center, 2006). It is also their responsibility to provide training for their health workers in terms of handling infectious items and patients. They should not expose their workers to risky health situations without ensuring that they have the adequate training in handling such health risks. Moreover, the health workers also have the responsibility of taking the proper precautions as imparted to them during their training in order to prevent increased risk for infection (MFL Occupational Health Center, 2006). Occupational hazards also include back injuries caused by heavy lifting and frequent bending or twisting during the moving of patients or objects (MFL Occupational Health Center, 2006). Repetitive strain injuries may also be seen among health workers especially after repetitive and awkward movements. These injuries often affect wrists, shoulders, backs, knees, and elbows; these injuries can also cause pain and weakness in the health worker (MFL Occupational Health Center, 2006). Exposure to radiation is also seen in the use of diagnostic procedures like X-Rays, fluoroscopy, and angiography. The treatment methods in some instances also involve the use of radioactive materials which health workers are exposed to. Long-term and repeated exposure to radiation can impact on health workers in terms of genetic cell damage and reproductive issues; light beams from lasers can also harm the health workers’ eyes and skin (MFL Occupational Health Center, 2006). Chemicals seen in hospitals can also take the form of dusts, vapors, gases, and other liquids and these chemicals can be breathed in, can penetrate the skin, or can be swallowed by the health workers and eventually cause serious illness (in some cases, death) (MFL Occupational Health Center, 2006). In effect, without the appropriate health precautions and protective measures provided to these health workers, they are invariably giving rise to legal issues within the health care workplace. The health administrators are obligated by law to provide accessible mechanical lifts and to make sure that all staff members know how to use these lifts; moreover, the staff members must also be trained in the proper techniques of lifting, bending, and carrying (MFL Occupational Health Center, 2006). Ergonomically appropriate tools must also be provided for staff members in order to prevent these occupational hazards. Adequate rest periods and breaks must also be provided for each staff member (MFL Occupational Health Center, 2006). The above remedies help prevent injuries and health risks; eventually, they help prevent the emergence of legal issues. In order to prevent injuries and eventual lawsuits from radiation and chemical exposure, the proper and adequate PPEs must be provided to the health staff. Proper procedures must also be taught to the workers in order to ensure protection; exposure time to radiation and chemicals must be minimized; and warning signs must be made visible where appropriate (MFL Occupational Health Center, 2006). In instances when the health administrators fail to ensure the protection of workers against these occupational hazards, possible legal issues against the health administrators can be raised in the proper venues. Violation of ethical principles There are four basic ethical principles in the healthcare practice. These principles are: self-determination (autonomy); beneficence; non-maleficence; and justice (Staunton, 2007). The principle of self-determination refers to the right of the patient to make informed decisions about his care. This mostly relates to the care which would be undertaken in his behalf (Staunton, 2007). Such care must be implemented with a mind to the personal choices of the patient. The health workers must respect the patient’s decisions and ensure that the patient makes informed decisions about his care (O’Connor, et.al., 2007). The patient may actually refuse care (DNR orders). Decisions such as these must be respected by the health professional or risk being sued by the patient for physical assault (unconsented touching) or for violating his oath as a medical professional (McLean, 2009). In applying the principle of beneficence, the health workers must implement or carry out actions which would bring benefit to the patient (Staunton, 2007). This is related to the principle of non-maleficence where the health worker must act in ways which would not bring the patient any harm (Staunton, 2007). In effect, actions which would not benefit the patient or which would instead bring him harm must be avoided. In instances when harm is brought upon the patient due to the health worker’s actions, the latter is liable to possible legal action from the patient. Issues like euthanasia or assisted suicide are actions which actually bring harm to the patient (Norval, 2008). For the most part, these are prohibited actions and must therefore not be applied on the patient, even with the patient’s consent. Most territories have still not legally allowed assisted suicide; hence any current actions to carry it out are considered legally actionable (Norval, 2008). Finally, the principle of justice is about giving a person his due or, in this case, about giving the patient his due (Staunton, 2007). This principle arises from the fulfillment of the basic requirements of a health professional. A patient deserves to be treated once he seeks medical attention from a health professional (Staunton, 2007). It is his due. The health professional is required to perform his essential roles and responsibilities based on the mandates of the laws and of his profession. Without the performance of such duties, a less than adequate performance of the justice principle is seen. Hence, legal responsibilities can be imposed. Conclusion There are different legal issues which arise in the healthcare workplace. In this paper, workplace violence, occupational hazards, and violations of ethical principles are three areas where these legal issues may be seen. Workplace violence includes the infliction of physical and psychological violence on health workers either by the patients or by other health professionals. Occupational hazards coming from communicable diseases, back injuries, strains, radiation, and chemical injuries can also arise to legal issues in the workplace, especially when the health administrators are not implementing means to prevent or modify these hazards. Finally violation of the ethical principles of self-determination, beneficence, non-maleficence, and justice are also sources of legal issues in the heath care practice. Failure to observe such principles, makes a health professional liable to legal action from the patient and from the health administrators. Works Cited Beech, B. & Leather, P. (2006). Workplace violence in the health care sector: A review of staff training and integration of training evaluation models. Aggression and Violent Behavior, volume 11, pp. 27– 43. King, J. (2007). Toward The ‘Tipping Point’: Decision Aids And Informed Patient Choice. Health Affairs, volume 26(3), pp. 716-725. Leonard, J., Norman, J., Spring, D. (2009). 9745: Violence in the Healthcare Workplace. National Collaborating Centre for Nursing and Supportive Care. Retrieved 29 March 2011 from http://www.netce.com/coursecontent.php?courseid=572 MFL Occupational Health Centre. (2006). Occupational Hazards for Hospital Workers. Retrieved 28 March 2011 from http://www.mflohc.mb.ca/fact_sheets_folder/hospital_hazards_revised.pdf Norval, D. (2008). Ethical decisions in end-of-life care. Continuing Medical Education Journal, volume 21, number 5, pp. 267-272. O’Connor, A., Wennberg, J., Legare, F., Llewellyn, H., Moulton, B., Sepucha, K., Sodano, A., & McLean, S. (2009). Autonomy, consent and the law. New York: Taylor and Francis Pozgar, G. (2007). Legal aspects of health care administration. Massachusetts: Jones & Bartlett Publishing Staunton, M. (2007). Nursing and the Law. New York: Elsevier Health Sciences World Health Organization (2011). Occupational health: the workplace. Retrieved 27 March 2011 from http://www.who.int/peh/Occupational_health/occupational_health2.htm Read More