Scenario 1: Nurse Deb was due for her annual flu vaccination as mandated by her hospital’s policy. Nurse Deb is a big supporter of the antivaccination movement and refused to obtain her annual flu vaccination. Upon notice that nurse Deb did not obtain the vaccination, the nurse manager fired Nurse Deb. Nurse Deb has decide to file a wrongful termination suit. As the director of nursing, how would you handle this situation?

Healthcare ethics

What evidence does Nurse Deb have that could help her win the case?

There could be some evidence that could help Deb win this case. If there was not a reasonable amount of time give to Deb to get her flu vaccination. The hospital could also be in the trouble if Deb could not get the shot for religious or medical reasons. There also could be a case for Deb if she was a part of a union. Some unions believe that medical professional should have the option to get a flu vaccination, “One analysis which compiled the results of three previous trials found that there was no evidence that vaccinating healthcare workers prevented any flu cases or associated complications in patients living in senior residences.” (foxusforhealth.org). There is not a lot that Deb has regarding winning her case. My suggestion to Deb would be to drop the lawsuit for wrongful termination. I assume that the flu vaccination was gone over with her when she was hired. In this case the hospital would also argue the employment at will which would allow them to terminate her at any time. “Moreover, most states recognize the doctrine of employment-at-will, under which employers can terminate a worker for any reason as long as a prohibited motivation, such as race or disability status, is not involved. In the absence of a proscribed rationale, vaccination can be used as a condition of continued employment.” (Field, 2009).

What law protects the hospital’s mandated vaccination procedures?

There are multiple laws that protect the hospital regarding these mandates. “Chapter 7 of the National Action Plan to Prevention Health Care-Associated Infections: Road Map to Elimination supports the influenza vaccination of health care personnel to protect health care personnel and their patients, as well as to reduce disease burden and health care costs.” (ODPHP, 2017). There is a lot of research stating that this vaccination is an ethical duty of a health care worker. From these laws the hospital has very little to worry about regarding this termination. “Those that support healthcare worker mandates of the flu vaccine argue that it is the ethical duty of healthcare workers to be vaccinated based on the concepts of non-maleficence and beneficence. It is argued that the flu vaccine is the best way to protect immunocompromised patients from getting the disease, therefore, if a healthcare worker refuses the vaccine, they could be causing harm and violating their ethical duty.” (focusforhealth.org)

How concerned should the hospital be if the lawsuit is a success?

As the director of nursing there are a few specific things that I would do regarding this case. Nurse Deb is filing the wrongful termination lawsuit due to her termination regarding her not getting her flu vaccination. Depending on the state which the hospital is in there could be an employment-at-will cause. This would allow nurse Deb to get fired for not getting her flu vaccination. There are also many states and facilities that mandate health care employees to get their flu vaccinations, “Vaccination coverage was highest (94.8%) among health care personnel working in settings where vaccination was required. Among health care personnel whose employers did not have a requirement for vaccination coverage was higher among those who worked in locations where vaccination was offered at the worksite at no cost for 1 day only (70.4%) or >1 day (76.0%) or who worked in locations where their employer did not. provide influenza vaccination on-site at no cost but actively promoted vaccination through other mechanisms (75.1%) compared with that among health care personnel working in locations where employers did not have any vaccination-related requirements or provisions (47.6%).” (cdc.gov). The hospital should have a policy and procedure regarding flu vaccination. The only way that this would be wrongful termination if there was a policy would be if Deb did not get the flu vaccination for religious or medical reason. It is very important for healthcare facilities to have these policies and procedures in place, “In the first year of the mandatory policy (2009–2010), 99.2 percent of employees received the vaccine, 0.7 percent were exempted for religious or medical reasons, and 0.1 percent refused vaccination and chose to terminate employment. The results were sustained: in 2012, 98.7 percent were vaccinated, 1.2 percent were exempted, and 0.06 percent refused vaccination.” (ODPHP, 2017). Overall because the hospital has a written policy stating that the flu vaccination is mandatory the hospital does not have much to worry about. My suggestion would be for Deb to drop with case because there is little to no evidence that supports her wrongful termination lawsuit.

Scenario 2: Joe Gomez worked as a plant operations specialist at Premier Hospital. While Joe’s manager was working on the HVAC system that protects patients from harmful viruses and bacteria, he noticed that he was not using OSHA-approved filters. Joe felt that it was important to report this to the compliance officer. The day following his report, Joe was fired by his manager.

As the CEO of Premier Hospital, how would you handle the situation? How concerned should you be about the termination of Joe?

I would be very concerned regarding the termination of the operations specialist Joe Gomez. Joe was terminated because he reported to the compliance officer that OSHA-approved filters were not being used. One the same day that the report was filed Joe was fired by his manager. The whistleblower act makes me very concerned regarding Joe’s termination.

What legal principles are involved?

f the company is in a employment at will state then the manager does not have to have a reasons to terminate him. I would also be very worried about Joe being protected by the whistleblower act, “A whistleblower is defined as someone who informs the authorities about a person or organization engaged in illegal or unacceptable behavior. OSHA’s whistleblower laws protect employees from employer retaliation, such as dismissal, discipline, harassment, and demotion. These are the important things to know about whistleblower labor laws. Seventeen Acts protect whistleblowers, which protect qualified employees from the following: Occupational Safety & Health Act (OSH Act) for complaints filed by protected employees about workplace safety and health hazards” (oshaeducationcenter.com). Legally I believe that it was wrongful termination of Joe because he reported a safty issue and his job would be protected. If joe reached out to a lawyer or to a OSHA representative the hospital could be a serious danger of a lawsuit. “Any adverse action that results directly from your efforts to improve safety and health on the job or the environment is considered discrimination. That includes dismissal; demotion; assignment to an undesirable job or shift; loss of seniority; denial of a promotion you otherwise would have received; denial of benefits earned, such as sick leave or vacation time; harassment; blacklisting with other employers; taking away company housing; damaging your credit at banks or credit unions; reducing pay or hours. To prove discrimination, OSHA must be able to show that your employer acted wrongly in demoting, firing, or transferring you because you complained about safety and health conditions on the job or the environment. You must have been treated differently than similar workers who did not complain about hazards. Further, the alleged discrimination must have occurred around the time you expressed your safety and health or environmental concerns.” (osha.gov).

If Joe was a member of the local employee services union, does this make the termination different?

 If Joe was a member of a union then I believe that union would fight this termination. As the CEO of the hospital I would have a conversation with Joe as soon as I heard about his termination. I would rehire him and apologize for the actions of the manager. I would also make sure that the correct filters were used for the safety of our staff and patients. I would also terminate the manger who wrongfully terminated Joe. A person who wrongfully terminates an employee for doing the right thing should never be in a management potion. These measures would be to limit exposure of the situation and try to avoid a lawsuit.

References

Field, R. I. (2009, November). Mandatory vaccination of health care workers: whose rights should come first? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810172/

Healthcare Worker’s Mandates and Exemptions for the Flu Shot. (2019, May 17). Retrieved from https://www.focusforhealth.org/healthcare-workers-mandates-and-exemptions-for-the-flu-shot/

Influenza Vaccination Information for Health Care Workers | CDC. (n.d.). Retrieved from https://www.cdc.gov/flu/professionals/healthcareworkers.htm

Odphp. (2018, November 7). Influenza Vaccination of Health Care Workers: A Patient Safety Imperative – News & Events. Retrieved from https://health.gov/news/blog/2017/08/influenza-vaccination-of-healthcare-workers-a-patient-safety-imperative/

Protecting Whistleblowers With Job Safety and Health Complaints. (n.d.). Retrieved from https://www.osha.gov/Publications/osha3164.html

The Complete Guide to Whistleblower Labor Laws. (n.d.). Retrieved from https://www.oshaeducationcenter.com/articles/whistleblower-laws/

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