Legal/Ethical staff issues

Nurses General Nursing

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I work in a small community hospital, emergency room. The hospital is very involved in this big push for customer service right now. Though many of the changes are patient based and generally well accepted, many of them are very insensitive and border on legal and ethical issues with staff. For instance, many workers have been forced to change uniforms with a week's notice, being measured for and getting one to two uniforms given to them, having to pay exorbitant prices if they want more (obviously having one uniform when you work 6 or 7 days in a row will be an issue). In the beginning of the year, nurses will be required to change to white uniforms, with no clothing allowance or uniforms given (i as well as most nurses spend several hundred dollars a year on the navy uniforms we have worn for years and now will have absolutely no use for). Starting today, we are no longer allowed to have any food or drinks anywhere on the unit, which i totally understand the food, but our break room is very out of the way from the rest of the unit, and anyone working 12 hr shifts in a busy er knows you are lucky if you get 10 mins to eat a lunch let alone get breaks where you can get something to drink. I don't see how i can be made to run like crazy all those hours and not be allowed to have a bottle of water in the nursing station, which is high enough to be totally out of view of any patients. Imagine telling someone in a desk job that they are allowed to drink only on their breaks, that's ludicrous. Also, and yes, i am a smoker, and beginning in jan 1, we are no longer allowed to smoke anywhere on hospital property, including outside, parking lots, etc, there will be no designated smoking area. The kicker is, leaving the hospital grounds is considered patient abandonment even if on a break or at lunch, and punishable by immediate termination. Can a job legally say what i can or can't do on a break?? any input from others going through something similar would be great.

i recently saw a patient with reactive airway disease react very badly to the smoke carried on clothing by a visiting family member. it was frightening for everyone concerned, especially the patient. rare, yes, but why take the chance?

omg! i always wondered if there was any harm 2 the patientsfrom smoke on visitors/nurses clothes! wow!

(i'm an ex-smoker of 7 yrs, so i do understand how hard it must be 4 u)x

I don't think any of it's illegal, unfortunately, and it's only unethical in that it's poor treatment of staff. Most hospitals don't have a clothing allowance, but it does seem like it's something I would offer if I was forcing my employees to purchase theirs from one specific company instead of just mandating a color/style. Definitely tax deductable, as others have said.

JCAHO is behind the no food/water at the nurses' station thing. It doesn't seem to get enforced where I work unless there's an inspection, and you can probably hide a small water bottle in your bag. It's a crappy policy, but it's not coming from your hospital. Are there at least drinking fountains in the hallways? That would be something to puch for, or one of those water coolers with disposable cups, so you aren't keeping beverages behind a desk. Again, I'm sure this is legal - I've had several non-nursing jobs where we were only permitted to drink on breaks, and not allowed to keep even covered containers sitting behind our station - you used a little paper cup each time and had to toss it. Fine if you like soda, annoying if you're a coffee addict like I am. I would also definitely start taking your breaks - use the time you used to use to smoke!

I'm also a smoker, although I'm trying to quit for about the 15th time starting 3 days ago (so maybe I'm an ex-smoker this week - haven't fallen off the wagon yet!). Many people are stating that their companies have gone to designated smoking areas - you're saying you don't even have that. Non-smokers don't usually understand just how addictive nicotine is, and how most of us have tried and failed to quit more times than we can count. Still, this seems to be legal too. Have you heard of the companies that are no longer hiring people who admit to smoking, then firing them if they're caught with a cigarette on their days off? Or the ones that are doing nicotine testing? I guess it saves on their health insurance...and so far these policies haven't been struck down by the courts. Do you clock out on your breaks? Then you should be able to leave campus, IMO. I'm not completely sure of the laws regarding abandonment though, and I work at a huge metropolitan hospital.

I agree whoever mentioned a union, I know they don't solve everything, but complaining all on your own will just get you fired. That's your other option - vote with your feet, and get as many of your coworkers to come with you as possible. Then be very detailed in your exit interview. Good luck to you, this is a lot of crap to deal with at once! I'm sorry...

I am wondering if any one has had to deal with a legal and ethical issue of those nurses that decided to stay with their patients during hurricane katrina. not knowing where their families were etc... but ethically decided to stay with their patients to make sure they were safe instead of the ones who went home. what do you think about their decision legally and ethically.

Specializes in Hospital Education Coordinator.

a union has no say in policy.

We went smoke free years ago and a lot of people saw it as an incentive to get healthy & drop an expensive habit. Smoking is anti-social. The writing is on the wall.

As for uniforms. That hurts. We did that too and I gave my old uniforms to Goodwill. Now you know what to ask for at Christmas.

Lastly, the eating/drinking issue. JCAHO and the Health Dept have rules about this. But a covered beverage container ought to be within compliance. I would ask the Quality nurse.

Also, do you have a patient satisfaction committee? Bet you do. Talk to them about the relationship of employee satisfaction to patient satisfaction. Make recommendations that could work. Good luck.

Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

The place I work at went smoke free last year too-- The entire property. Smokers have to go across the road to a gas station.For our 15 min break we have to stay on grounds (breakroom). For the 30 min lunch break, we can punch out and leave. I think corporate was hoping that it would encourage people to quit smoking or look good on paper, but it just makes for crabbier staff so far. I'm glad I don't have that monkey on my back anymore... I quit smoking when my mom died of cancer.

Also we cannot have beverages or food around the nursing area, only in the break room. I am pretty sure that's quite universal being an infection control thing. Get used to grabbing sips out of the drinking fountains or in the bathroom in-between patients and breaks.

I don't know if I'd like being measured, but it does suck when you have to buy all new uniforms. I think it can be written off as a work expense in your taxes, so ask about that and keep receipts.

The place I work at went smoke free last year too-- The entire property. Smokers have to go across the road to a gas station.For our 15 min break we have to stay on grounds (breakroom). For the 30 min lunch break, we can punch out and leave. I think corporate was hoping that it would encourage people to quit smoking or look good on paper, but it just makes for crabbier staff so far. I'm glad I don't have that monkey on my back anymore... I quit smoking when my mom died of cancer.

Also we cannot have beverages or food around the nursing area, only in the break room. I am pretty sure that's quite universal being an infection control thing. Get used to grabbing sips out of the drinking fountains or in the bathroom in-between patients and breaks.

I don't know if I'd like being measured, but it does suck when you have to buy all new uniforms. I think it can be written off as a work expense in your taxes, so ask about that and keep receipts.

if you are going to try to take a tax break.....group ALL your expenses in one year that you can....many of us make too much money to qualify, ie meet the, I think, 7.5% of AGI......

Specializes in Critical Care, Orthopedics, Hospitalists.
For instance, many workers have been forced to change uniforms with a week's notice, being measured for and getting one to two uniforms given to them, having to pay exorbitant prices if they want more (obviously having one uniform when you work 6 or 7 days in a row will be an issue). In the beginning of the year, nurses will be required to change to white uniforms, with no clothing allowance or uniforms given (i as well as most nurses spend several hundred dollars a year on the navy uniforms we have worn for years and now will have absolutely no use for).

Hey, at least you're getting two sets of uniforms given to you! I personally think that designated colors for different departments is great because it makes it easy for patients and families to know who is who. Donate your old uniforms to goodwill and buy your new uniforms before the end of the year and put both items on your tax return. We had a similar issue a few years ago wherein our CNO decided she wanted nursing personnel to wear white, blue, or black shoes only - we got an allowance to cover this, and everyone looked very professional. A much sillier requirement than white scrubs. ;)

Starting today, we are no longer allowed to have any food or drinks anywhere on the unit, which i totally understand the food, but our break room is very out of the way from the rest of the unit, and anyone working 12 hr shifts in a busy er knows you are lucky if you get 10 mins to eat a lunch let alone get breaks where you can get something to drink. I don't see how i can be made to run like crazy all those hours and not be allowed to have a bottle of water in the nursing station, which is high enough to be totally out of view of any patients. Imagine telling someone in a desk job that they are allowed to drink only on their breaks, that's ludicrous.

This is pretty much a Joint Commision standard that your facility just hasn't caught up with yet. We've never been allowed to have drinks or food at the nurses station due to the risk for contamination of patient body fluids or something like that. What we did is we had our Infection Control nurse come by and give us a designated "clean" area - literally a red-taped square where we are allowed to keep our drinks. I'd suggest doing the same.

Also, and yes, i am a smoker, and beginning in jan 1, we are no longer allowed to smoke anywhere on hospital property, including outside, parking lots, etc, there will be no designated smoking area. The kicker is, leaving the hospital grounds is considered patient abandonment even if on a break or at lunch, and punishable by immediate termination. Can a job legally say what i can or can't do on a break?? any input from others going through something similar would be great.

Sorry again, this is pretty much the standard. I'm not a smoker, but I will say that those who still smoke on our campus have found that personal vehicles are a safe haven. Quitting is much easier and less stressful, though. ;)

Specializes in ED.

Actually there is no JCAHO has no written policy on food or drink at the nurse's station. It is left to the discretion of the institution. I only know this because we were having the same issues with the management who spouted JCAHO as being the reason why. So I looked it up. What a surprise. Anyways, having a union can help when an institution tries to mandate new practices. Something to consider.

Actually there is no JCAHO has no written policy on food or drink at the nurse's station. It is left to the discretion of the institution. I only know this because we were having the same issues with the management who spouted JCAHO as being the reason why. So I looked it up. What a surprise. Anyways, having a union can help when an institution tries to mandate new practices. Something to consider.

OSHA is usually given the "credit" for the no beverage at the n.s. rule....

Specializes in Community Health, Med-Surg, Home Health.

I know it is against the rules, but most nurses work around the food deal, especially in busy places. If I think that I might get a bit lightheaded, but can't take a break, I have no issues with having something like a breakfast bar in my pocket and sneaking to the bathroom, or behind a closed door to take a bite. Water/drink is kept in discrete places and we keep it moving. We try to survive and we hide when we have to.

I do smoke, and yes, my facility will join the smoke free gang on 11/20. Now, I work in a clinic with plenty of nurses, so it is a bit different for us, but when I do take that cigarette break, I make sure that it is a time when there is a serious lull in the clinic and I do tell one person where I am honestly going. I take a walk down the block, away from the hospital and patients, do my thing and come back. Hasn't interfered yet, but if it did, then, I would adjust.

I understand your dilemma; I just think that you have to make a choice to not get that aggreviated...you'll either change your eating habits to accomodate them, or work around it where no one knows...sneaking a bite when you need it (NEVER around patients) and don't tell a soul.

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