Termination for refusal to treat HIV-positive patients.
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Employers are frequently confronted with workers who do not perform adequately. It is important to document and communicate dissatisfaction with an employee's performance as failings become evident. Efforts at remediation of the deficiencies must also be recorded. This article outlines the pitfalls of employee discharge without such documentation and strategies to avoid litigation and achieve an equitable outcome for both parties.
Four cases in which health care workers sexually assaulted patients show the "gray area" of hiring or supervisory negligence.
Nurses must set professional boundaries for their relationships with patients. You can teach them the meaning of boundary crossings, boundary violations, and staying in the lines.
A participatory evaluative method was used to assess the effectiveness of mediation as carried out by the College of Nurses of Ontario. Qualitative methods were used to examine 34 cases between 1994 and 1998, of which 23 had been successful and 11 aborted. For purposes of comparison, the researchers developed a template of interviews with College personnel and documents, incorporating the College's philosophy and expectations of the process. Semistructured interviews were conducted with 44 participants in the mediation process. In addition, focus group sessions were held with Investigators and Practice Consultants. The data were analyzed using the template and themes were generated. The process was found to be stressful for all parties but was also found to be educational, to address system complaints, and to achieve initial goals. The College was found to be powerless to demand system reforms and to be dependent on the cooperation of each facility.
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