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chapter 12 | Promoting a Healthy Workplace 189 CikguOnline
institution, agency, or larger system (ANA, 2001). politically active by contacting your state legislators
The sources of various federal and state guidelines and urge them to support a pending bill or by edu-
governing the workplace are listed in Box 12-7. cating your elected state officials on the need
Protection by the agency should be afforded to for such protection for all health-care workers; and
both the accused and the person doing the report- (d) contact your U.S. congressional representatives
ing. Whistleblower is the term used for an employee and urge them to support the Patient Safety Act
who reports employer violations to an outside (nursingworld.org/tan/98janfeb/nlrbmass).
agency. Do not assume that doing the right thing It is the responsibility of professional nurses
will protect you. Speaking up could get you fired to become acquainted with the state and federal
unless you are protected by a union contract or regulations, standards of practice and professional
other formal employment agreement. In May performance, and agency protocols and practice
1994, the U.S. Supreme Court ruled that nurses guidelines governing their practice. Lack of knowl-
who direct the work of other employees may be edge will not protect you from ethical and legal
considered supervisors and therefore may not be obligations. Your state nurses association can help
covered by the protections guaranteed under the you seek information related to incompetent,
National Labor Relations Act. This ruling may unethical, or illegal practices. When you join your
cause nurses to have no protection from retaliation state association, you will gain access to an organi-
if they report illegal practices in the workplace zation that has input into policies and procedures
(ANA, 1995b). The 1995 brochure from the ANA designed to protect the public.
(1995a), Protect Your Patients—Protect Your License, Although the rights of disabled nurses are not
states, “Be aware that reporting quality and safety usually considered “questionable practices,” the
issues may result in reprisals by an employer.” Does ANA is concerned with those rights. The
this mean that you should never speak up? Case Americans With Disabilities Act, enacted in 1990,
law, federal and state statutes, and the federal False makes it unlawful to discriminate against a quali-
Claims Act may afford a certain level of protection. fied individual with a disability. The employer is
Some states have whistleblower laws. They usually required to provide reasonable accommodations for
apply only to state employees or to certain types of the disabled person. A reasonable accommodation
workers. Although these laws may offer some pro- is a modification or adjustment to the job, work
tection, the most important point is to work environment, work schedule, or work procedures
through the employer’s chain of command and that enable a qualified person with a disability to
internal procedures: (a) make sure that whistle- perform the job. Both you and your employer may
blowing is addressed at your facility, either through see information from the Equal Employment
a collective bargaining contract or workplace advo- Opportunity Commission (EEOC) for informa-
cacy program; (b) contact your state nurses associ- tion (nursingworld.org/dlwa/wpr/wp6).
ation to find out if your state offers whistleblower
protection or has such legislation pending; (c) be Terrorism and Other Disasters
Since the attacks on the World Trade Center and
box 12-7
the Pentagon as well as the anthrax outbreaks and
Laws Governing Health-Care Practices continued terrorist threats nationwide, concerns
• State nurse practice acts related to biological and chemical agents have sur-
• Federal and state health regulations faced. The CDC Web site (bt.cdc.gov/) supports
• State and federal pharmacy laws for controlled substances ongoing information related to public health emer-
• OSHA
• State medical records and communicable disease laws gency preparedness and response. The ANA has
• Environmental laws regulating hazardous waste and air published a position statement for employers on
and water quality work release during a disaster. In addition, the ANA
• CDC guidelines provides RNs with valuable information on how
• Federal and state antidiscrimination laws they can better care for their patients, protect them-
• State clinical laboratory regulations
• JCAHO regulations selves, and prepare their hospitals and communities
to respond to acts of bioterrorism and natural disas-
Adapted from American Nurses Association. (1994). Guidelines on Reporting
Incompetent, Unethical, or Illegal Practices. Washington, DC: ANA. ters (nursingworld.org/news/disaster/).For example,