Please read chapters 1 and 3 along with the articles located in the reading material section and then address the discussion board questions for the week both chapters are uploded and articles copy and pasted
Sunshine State Hospital is unionized, and represented by Local 2001 – Nurse Professional Association.
ABC News – Nurses Fired for Refusing Flu Shot (ABC News) (January 4, 2013)
An Indiana hospital (Links to an external site.) has fired eight employees, including at least three veteran nurses, after they refused mandatory flu (Links to an external site.) shots, stirring up controversy over which should come first: employee rights or patient safety. The hospital imposed mandatory vaccines, responding to rising concerns about the spread of influenza.
Ethel Hoover wore all black on her last day of work as a nurse in the critical care unit at Indiana University Health Goshen Hospital. She said she was in “mourning” because she would have been at the hospital 22 years in February, and she’s only called out of work four or five times in her whole career , she said.
“This is my body. I have a right to refuse the flu vaccine,” Hoover, 61, told ABCNews.com. “For 21 years, I have religiously not taken the flu vaccine, and now you’re telling me that I believe in it.”
More than 15,100 flu cases have been reported (Links to an external site.) to the Centers for Disease Control and Prevention since Sept. 30, including 16 pediatric deaths. Indiana’s flu activity level is considered high, according to the CDC (Links to an external site.), which last month announced that the flu season came a month.
When Hoover first heard about the mandate, she said she didn’t realize officials would take it so seriously. She said she filed two medical exemptions, a religious exemption and two appeals, but they were all denied. The Dec. 15 flu shot deadline came and went. Hoover’s last day of employment was Dec. 21.
Fellow nurse Kacy Davis said she and her colleagues were “horrified” over Hoover’s firing, calling her their “go-to” nurse and a “preceptor.”
“It was a good place to work,” Hoover said. “We’ve worked together all these years. We’re like a family.”
The hospital said in a statement that it implemented the mandate to promote patient safety based on recommendations from the American Medical Association, the American Nurses Association, and the Centers for Disease Control and Prevention. It announced the mandate in September. Of the hospital’s 26,000 employees statewide, 95 percent complied. That means 1,300 employees did not comply, but only eight were fired.
“IU Health’s top priority is the health and wellbeing of our patients,” said hospital spokeswoman Whitney Ertel. “Participation in the annual Influenza Patient Safety Program is a condition of employment with IU Health for the health and safety of the patients that we serve, and is therefore required.”
The CDC recommends (Links to an external site.) flu shots for everyone older than six months of age. Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., said hospital patients are especially vulnerable to flu complications because their bodies are already weakened.
“I cannot think of a reason for any health care professional to decline influenza immunization that’s valid,” said Schaffner, a former president of the National Foundation for Infectious Diseases, adding that people with egg allergies may have to avoid the flu shot to prevent anaphylactic shock, but even that hurdle has been remedied. The Food and Drug Administration approved an egg-free vaccine (Links to an external site.) in November.
Schaffner said invalid excuses to avoid the shot include being afraid of needles and simply promising to stay home when they’re sick. Patients now have the option of a vaccine nasal spray if they want to avoid needles. And since flu victims become contagious before they start to feel sick, they can get patients sick even if they stay home when they have symptoms.
Over the last several years, hospitals have been moving toward mandatory vaccinations because many only have 60 percent vaccination rates, Schaffner said. He is leading an effort for a similar mandate at Vanderbilt University Medical Center.
Nurses in particular tend to be the most reluctant to get vaccinated among health care workers, Schaffner said, citing his opinion.
“There seems to be a persistent myth that you can get flu from a flu vaccine among nurses,” he said. “They subject themselves to more influenza by not being immunized, and they certainly do not participate in putting patient safety first.”
In October 2011, Vanderbilt broke the world record for number of vaccines administered in an eight-hour period in an event called Flulapalooza. (Links to an external site.) From 6:50 a.m. to 2:50 p.m., they vaccinated 12,647 people. By that evening, more than 14,000 people had been vaccinated, and there were no severe adverse reactions, he said.
But still, Hoover’s lawyer, Alan Phillips, says his client had the right to refuse her flu shot under Title VII of the Civil Rights Act of 1964 (Links to an external site.), which prohibits religious discrimination of employees. Religion is legally broad under the First Amendment, so it could include any strongly held belief, he said, adding that the belief flu shots are bad should suffice.
“If your personal beliefs are religious in nature, then they are a protected belief,” Phillips said.
Phillips, who is based out of North Carolina, has made a name for himself fighting for employees’ rights to get out of mandated flu shots, but he has never needed to go to court. Although he usually handles a couple dozen health care workers per year, he had 150 this fall in 25 states.
Dr. Damon Raskin, an internist with his own practice in the Pacific Palisades in Los Angeles, said hospitals should mandate flu vaccines as a matter of public safety. The flu can lead to complications like pneumonia and death, said Raskin, who is also affiliated with the Cliffside Malibu Addiction Rehabilitation Center.
“I think if the health care worker has some problem with religious faith then perhaps during flu season, they shouldn’t do that job,” Raskin said, suggesting that the worker do something administrative instead during flu season. “It’s not fair to the patient. The people who are most at risk are in the hospital.”
Talks with Jim CollinsJim Collins speaks at the SHRM 2012 Annual Conference. Photo by Steven E. Purcell
ATLANTA—“The single most important strategic pillar of any great enterprise is people,” best-selling author Jim Collins said in his Tuesday keynote session at the SHRM 2012 Annual Conference.
After spending nine years studying why some companies thrive in uncertainty or even chaos, while others do not, for his latest book Great by Choice: Uncertainty, Chaos, and Luck—Why Some Thrive Despite Them All (HarperBusiness, 2011), Collins concluded that “it all begins with people.”
The most important executive skills for building a great organization are “the ability to pick the right people, to make disciplined people decisions and to make sure all key seats are filled with the right people,” Collins told attendees.
Collins, whose previous works include Good to Great, How the Mighty Fall and Built to Last, has spent nearly a quarter of a century studying great companies that endure—how they grow, how they attain superior performance, and how good companies can become great companies.
“It’s very dangerous to study success … so we don’t,” he said. “We study the contrast between success and failure … between great and good.
“Greatness is not primarily a function of circumstance … it is a matter of conscious choice and discipline,” he noted.
Level 5 Leaders
Collins described five levels of leadership competence. The first level includes highly capable individuals, followed by contributing team members at level two, competent managers at level three, effective leaders at level four and executives at level five.
According to Collins’ research, the greatest leaders share a common trait: they are level five leaders. “Level five leaders have an ‘X factor’ that is different than level four leaders,” Collins explained: humility.
Though Collins mentioned a few great leaders with “very healthy confidence,” such as Bill Gates and Steve Jobs, he said that the critical difference is that for level four leaders, “it really is about them.” By contrast, level five leaders’ “ego and ambition and confidence and drive are channeled outward into a cause, into a purpose, into an organization or into a quest that is not about them,” he said.
“Success coupled with arrogance inevitably leads to failure,” he added. “It is outrageous arrogance to neglect people and simultaneously expect them to deliver their best.
“No single leader by himself or herself can make a great company,” Collins added. “Level five leaders understand this; they have to build an entire team to make a company great.”
Triad of Behaviors
Level five leaders possess other key behaviors, Collins has found. These include:
Fanatic discipline. Such leaders are “disciplined people who engage in disciplined thought and who then take disciplined action.” But he warned attendees not to confuse discipline with bureaucracy. “The purpose of bureaucracy is to make up for undisciplined people,” he said.
As an example, Collins compared Roald Amundsen’s successful 1910-12 South Pole expedition and Robert F. Scott’s ultimately fatal Antarctic expedition during that same time to describe the kind of discipline level five leaders use to pursue results. “Discipline also means not going too far,” he said.
Empirical creativity. “Creativity is the natural human state … discipline is not,” Collins noted. “The really rare combination is finding out how to marry the two so we amplify creativity rather than destroy it.
Productive paranoia. “The only mistakes you can learn from are the ones you survive,” Collins noted. This means preparing before bad stuff happens, he said. The ultimate hedge against uncertainty, he said, is who you have on the other end of the rope.
Right People for Key Seats
When looking for people to hold key seats, Collins said level five leaders seek those who:
• Share core values.
• Don’t need to be tightly managed.
• Understand they do not have a job; they have responsibilities.
• Do what they say they will do 100 percent of the time.
In addition, such individuals tend to look outward when good things happen, and give credit to others. However, when bad things happen they look in the mirror and take responsibility.
“It all starts and ends with people,” he noted.
Collins ended the session with a “to do list” for attendees that reiterated some of the points he made throughout the session. Among his suggestions:
• Banish the word “job” and replace it with “responsibilities.”
• Start a “stop doing” list. “Work is infinite; time is finite,” he said. “If you have more than three priorities, you have none.”
• Commit to challenging all young leaders to become level five leaders. “We need legions,” he said. “We need a level five generation.”
Rebecca R. Hastings, SPHR, is an online editor/manager for SHRM.
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