Unit 7 Reading
When we think of labor relations, we automatically think about unions, but labor relations also include non-unionized employees in healthcare organizations as well.
Many healthcare facilities like hospitals are unionized and have collective bargaining units representing their employees. The National Labor Relations Act governs these collective bargaining units. This law requires that both employees and employers follow specific regulations and procedures to create and maintain union status. The law prevents either side from using unfair labor practices. The law applies to healthcare unions just like all other unions. Employees must pay dues to the union, and employers cannot discriminate against employees because of bargaining status.
In addition to prohibitions on union discrimination, employers may not discriminate upon the basis of race, color, age, religion, sex, or national origin. This applies to all employers, including healthcare organizations. The Occupational Safety and Health Act (OSH Act) also applies to all employers, but employees in the healthcare field face unique safety challenges that others do not. The OSH Act requires employers keep employees safe from workplace hazards. Employees have the right to be free from injury due to workplace hazards.
Healthcare employees also have the same protections as all employees when it comes to leave time and job protections. The Family Medical Leave Act (FMLA) requires that eligible employees may take up to 12 weeks of approved leave without losing their jobs. Other workplace protections include workers’ compensation. Worker’s compensation allows employees to be paid a portion of their income after they are injured and cannot work.
For example, a nurse is conducting her patient rounds. She does not notice some type of substance on the floor and slips and falls. She falls directly on her side and injures her hip. Later, it is discovered that the substance was oil from when a maintenance man was repairing a copier at the nurses’ station and did not notice that he spilled a little machine oil in the hallway floor. The nurse is in pain and needs to recover. She is not able to work for some time. In this instance, the nurse would be covered under workers’ compensation and would receive a percentage of her paycheck while she was not able to work. Workers’ compensation was designed as a no-fault insurance provided by the employer. It means that the employee is guaranteed coverage, within some guidelines.
Even though some hospitals are unionized, most employees of any organization are subject to at-will status. At-will means that an employee not under contract can be terminated for any reason or no reason at all provided it is not discriminatory. There are a few exceptions worth noting, including whistleblowing and public policy, but at-will employment provides little job protections for employees.
Whistleblowers expose criminal or unethical behaviors in an organization. They are protected under state and federal whistleblower statutes.
For example, imagine that you are a billing clerk for a hospital. You are routinely performing your job and paying bills until you notice some of the bills you are paying for a specific physician look like they might be double billing for the same patients. The patients that appear to be double billed are only Medicare patients. You ask your supervisor about it, and he says that maybe it is a mistake and maybe it is not. He goes on to say that it does not really matter that much as Medicare is a guaranteed payer. The supervisor also says that it is a federal program and can afford it and that the hospital routinely rotates which doctor double bills their senior patients. However, he says, the hospital only does it for Medicare patients. This is, of course, unethical and also illegal. You do not feel comfortable knowingly participating in fraud. You go to your supervisor again to let him know you are going to go higher up if the situation is not corrected. He actually agrees with your conclusion, and he says he will take it to management.
A couple weeks go by, and you are still getting these fraudulent bills. You go back to your supervisor, and he says they are working on a resolution. Fearing he is just telling you what you want to hear and that there will be no change in billing, the next day you report this billing fraud directly to the Medicare fraud division. This happens on a Friday. You return to work on Monday to realize your job has been eliminated, and you have been dismissed.
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In this scenario, you may be able to bring a wrongful termination claim under your state or federal whistleblower laws. Some statutes even provide for a percentage of the penalties to be paid as a reward to the whistleblower.
Employers, like the one in the above situation, are prohibited by law from retaliating against an employee who acts as a whistleblower for an illegal or unethical organization. This protection supersedes any at-will status.
All employers are required to provide safe work environments. They are required to protect employees’ privacy and confidentiality. Employees, specifically in health care, are, in return, expected to provide quality patient care, maintain patient privacy and confidentiality, and always maintain professional standards.
Professional standards can vary depending upon the employee’s position with the organization. Typically, this includes maintaining any professional certifications and licensing. Certain employees may be required to carry additional professional liability insurance as a condition of employment.
Professional liability insurance generally protects against malpractice and negligence claims. This coverage may be above and beyond any coverage provided by the employer. Most of these policies have exceptions for intentional or criminal acts.
For example, Amy is a nurse for a city hospital. One day she is served with legal papers indicating that she is named in a malpractice lawsuit that has been brought against a doctor for whom she previously worked. She is very surprised and, of course, upset by the lawsuit. She has her own professional liability policy, and she contacts her insurance company that immediately assigns a case manager and an attorney for her representation. After a lot of back and forth, it is discovered that Amy was not present at the hospital the day that the patient is claiming the negligence occurred. Amy’s individual professional liability insurance policy covered her expenses, and she is completely dismissed from the claim. This added level of protection and security is why many professionals maintain their own liability policy separate from any group employer coverage.
However, if Amy had been charged with sexual harassment or sexual assault, Amy’s individual professional liability policy would not have covered her. Her employer’s group policy also would not cover her. It would still cover the hospital in order to defend itself against employee or patient legal actions, but Amy would be on her own for any criminal claims against her.
Healthcare employers and employees have rights, responsibilities, and obligations to each other. All these rights and obligations are created to work together to maximize the safety and privacy of employees and patients in the healthcare system.
