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PubMed1996

Coerced treatment for substance abuse problems detected through workplace urine surveillance: is it effective?

With the advent of on-site urine testing and other initiatives designed to reduce substance abuse at the workplace, employees who are found to have used alcohol and/or drugs have been coerced into substance abuse treatments under threat of job loss. This widespread practice has produced three questions relative to these practices. First, do these employees have significant substance abuse problems or are they merely "recreational users" who have gotten caught? Second, will these employees participate in standard treatments or will they resist them? Finally, will standard substance abuse treatments provide any benefits to these coerced patients relative to other self-referred patients in treatment? We compared the pretreatment problems, during treatment performance and posttreatment outcomes of 96 employed, insured participants who were coerced into treatment at four private treatment programs due to detection of drug use on the job, to the same measures collected on a comparison group of 161 patients from the same job sites who were self-referred admissions to the same four treatment programs. Results showed that the coerced group had significant substance abuse and other life problems at the start of treatment, but that these problems were generally less severe or chronic than those of the self-referred group. Coerced participants were significantly more likely to remain in treatment (either inpatient or outpatient) than the self-referred participants. Posttreatment follow-up of coerced patients indicated marked improvements in alcohol and drug use, employment, medical, family, and psychiatric problems. These levels of improvement were comparable to those shown by the self-referred patients. We conclude that workplace urine surveillance was successful in detecting employees with significant substance abuse related problems, and that referral to standard treatment was associated with substantial improvements in those problems.

Adult↗
PubMed1997

Bracing yourself to deal with the top 10 employment law problems.

Orthodontists face a number of legal problems in dealing with employment issues. Some of them are similar to those effecting other professionals, whereas other problems are peculiar to the practice of orthodontia. An experienced employment attorney offers recommendations to deal with 10 common issues confronting orthodontists in the workplace.

Employee Discipline↗
PubMed1997

Effects of training in procedural justice on perceptions of disciplinary fairness by unionized employees and disciplinary subject matter experts.

A training program, based on procedural justice theory, was developed for teaching supervisors to take effective disciplinary action with employees. Canadian supervisors of unionized employees were randomly assigned to the training (n = 35) or the control group (n = 36). Analyses of variance revealed that both supervisory self-efficacy and outcome expectancies were significantly higher in the training than in the control conditions. Following simulated role-play exercises derived from organizational incidents, both unionized employees and disciplinary subject matter experts (managers, union officials, and attorneys) rated the trained supervisors higher on disciplinary fairness behavior than the supervisors in the control group. Self-efficacy was found to mediate the relationship between training and perceptions of disciplinary fairness.

Adult↗
PubMed2005

To do today.

Explore the source record for details and available documents.

Efficiency, Organizational↗
PubMed2000

Nurses and whistleblowing: the ethical issues.

Whistleblowing - the public exposure of organizational wrongdoing - presents practical and ethical dilemma for nurses, and needs to be seen as part of a spectrum of increasingly confrontative actions against miscreant organizations by their employees. The ethics of whistleblowing can only be understood in relation to its moral purpose, whether that is to achieve a good outcome (a consequentialist view) or fulfil a duty (a deontological view). The consequentialist perspective is unable on its own to resolve problems arising from the balance of good and harm resulting from the act of whistleblowing (where considerable harm might be caused) or of responsibility for that harm. A deontological approach provides an analysis of these problems but raises its own problem of conflicting duties for nurses. However, a strong argument can be made for the precedence of the nurse's duty to the patient over her duty to the employer. Although both duties are based on an implicit or an explicit promise, the promise to a person (the patient) must take precedence over the promise to an organization. It can even be argued that duty to the employer may in fact justify whistleblowing by nurses in some circumstances. However, the consequences of whistleblowing are forced upon nurses in a different way by the fact that the danger of reprisals acts as a deterrent to whistleblowers, however justified their actions may be. A more robust approach to the protection of whistleblowers is needed on the part of the government and the National Health Service (NHS) to remedy this situation.

Attitude of Health Personnel↗
PubMed1998

Disciplinary power and its influence on the administration and supply of medications by nurses in rural areas of Australia.

This paper reports on aspects of a larger study into rural nursing practice in Australia, 1991-94 (D. Hegney, unpublished data, 1996). Using a Foucauldian framework for analysis of the rural nursing discourses, it presents an interpretation of the statements regarding the administration and supply of medications in rural nursing practice. In particular, it focuses on the supply and administration of medications by rural nurses working in small rural health services. It explains that there are particular issues regarding telephone medication orders and the consequent verification of these orders. It suggests that rural medical practitioners use the power of legislation with regard to the administration and supply of medications to subjugate rural nursing practice. It argues that the nursing profession itself has used, through its silence on the inadequacy of the current Poison Acts and their Regulations, disciplinary power to ensure that rural nursing practice is normalised to metropolitan nursing practice. Further, the lack of educational preparation for this rural nursing role, can be seen as a pedagogical control of rural nursing practice. This paper recommends that the Statute Law regarding the administration and supply of medications be changed to reflect the reality of rural nursing practice, and that rural nurses are prepared adequately for this aspect of rural nursing practice.

Attitude of Health Personnel↗
PubMed2001

Nurses and medication error: a discursive reading of the literature.

Medication management is a part of everyday nursing practice. In carrying out this aspect of their role, nurses are subject to a range of practices and procedures, which are dictated through legal, management and medical requirements to ensure safe administration of medications. The literature addresses a range of areas related to the nurse's role in medication management, including knowledge required by nurses, practices and procedures related to administration, procedures for identifying and reducing errors and measuring error rates, and professional and ethical issues. The literature is a part of the discursive ensemble of nursing - as a written text it contributes to how nurses and colleagues construct and view nursing practice. This paper presents a discursive reading of that literature, exploring how nurses are positioned in relation to medication errors. I argue that the voice of nursing is mostly heard through discourses of biomedical science, law and management and draw on the work of Michel Foucault to illustrate some of the ways in which these discourses shape nursing practice.

Attitude of Health Personnel↗
PubMed1997

Thoughts before whistling.

Whistleblowing is a public alert by an insider of an organisation to a practice or concerning potential they observe in the organisation. This paper proposes that the risk, values at stake, timeliness and manner of complaint be considered before a whistle is blown. It also notes education and monitoring mechanisms.

Australia↗