Nursing Responsibilities Flashcards
Nurses in a unionized hospital are paid “compensatory pay” when working holidays equal to the number of hours worked with no extra compensation. Although they have suggested changes during the annual survey of employee satisfaction, management refuses to consider another system for compensatory pay. A trained member listed to both nurses and management to make recommendations that were not legally binding. This type of settlement is referred to by what term?
A. Collective bargaining
B. Binding arbitration
C. Mediation
D. Grievance
C. Mediation
Rationale: Mediation enlists the help of a trained person to listen to both sides; however, recommendations are not legally binding. Collective bargaining is a process whereby workers organize under the depredation of a union in order to share a degree of power with management to determine selected aspects of the conditions of employment. Binding arbitration means that ll parties must obey the arbitrator’s recommendations. Grievance is a term associated with a negative workplace event that results in an allegation by an employee that he or she has not been treated fairly and equitably.
A nurse has been asked to serve as the charge nurse on the evening shift. The agency where the nurse is employed is considering unionization. If the nurse accepts the role, what affect will unionization have on the nurse’s new position?
A. The nurse can be represented by the union because charge nurses aren’t considered part of the management team
B. Charge nurse is part of the management team, so union participation would be a conflict of interest
C. The nurse can file a grievance that will be arbitrated automatically by the union
D. The nurse is ineligible for collective bargaining activities that deal with unfair labor practices
A. The nurse can be represented by the union because charge nurses aren’t considered part of the management team
Rationale: serving as charge nurse is part of the nurse’s professional role and not a management function
A nurse has heard rumors that other nurses are interested in unionizing but knows little about the purpose of unions. What should be the nurse’s first action?
A. Contact an arbitrator who has worked with other nurses in unions
B. Question the agency where employed to gain inside information as to why unionization is sought
C. Sign the dual-purpose union authorization card
D. Review the National Nurses United website for collective bargaining information
D. Review the National Nurses United website for collective bargaining information
Rationale: The National Nurses United website gives information about collective bargaining for nurses. None of the other options are as likely to provide unbiased information on the topic
Nurses in a nonprofit hospital have expressed an interest in forming a union to secure fair wages and ensure client safety. To form a core support group of nurses, where should the union organizer conduct meetings to gather initial information?
A. Away from the worksite with a group of managers to learn both sides of the situation
B. At the worksite with staff nurses who are respected leaders
C. In homes or local businesses with staff nurses
D. At the facility to discuss nursing concerns
C. In homes or local businesses with staff nurses
Rationale: the union representative meets with laborers (staff nurses) at a non-work setting to gather info about grievances
Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. A nurse is approached to sign a union authorization card. What is the purpose of a signed union authorization card?
A. It authorizes the union to serve as his or her legal representative
B. It indicates that the person is requesting additional information about collective bargaining
C. It indicates the nurse desires to share information about grievances
D. It gives permission for union dues to be deducted from pay
A. It authorizes the union to serve as his or her legal representative
Rationale: a signature of a union authorization card indicates that the nurse gives the union the right to serve as legal representation
A group of RNs wish to seek union representation that would protect all workers in the agency including non-licensed assistive personnel and non-nursing employees such as nutritionists and dietary workers. The type of union being sought is the strongest collective group and is known by what term?
A. An occupational union
B. An industrial unionism
C. A union shop
D. A right-to-work bargaining organization
B. An industrial unionism
Rationale: an industrial union is a single union for all workers in the agency. Occupational unionism is a type of union in which each occupation within a given company has separate unions. Union shop refers to a worksite that requires all new employees in a specific work group to join the union. A nurse in a right-to-work state can choose not to become a union member yet receive the benefits from the union contract
Physical therapists are represented by a union, nurses are represented by a separate union, and pharmacists have yet another union within a single agency. This type of union representation is known by what term?
A. Occupational unionism
B. Industrial unionisms
C. Union shop
D. Power sharing
A. Occupational unionism
Rationale: occupational unionism indicates separate unions for each occupation in an agency
Historically, what movement most influenced unionization in American health care agencies/hospitals?
A. Immigration laws protected foreign employees from discrimination in hiring or discharge based on national origin and citizenship status
B. Women entered the workforce, gaining voice to support unions
C. The Industrial Revolution led to poor working conditions and the need to protect workers
D. Nurses were exposed to communicable disease, which led to death and disability
C. The Industrial Revolution led to poor working conditions and the need to protect workers
Rationale: the Industrial Revolution led to people working in factories where poor and unsafe working conditions were widespread
In recent Gallop Polls, nurses were voted as the most honest with the highest ethical standards of all professions. How does this degree of professionalism affect nurses’ desire to participate in organized strikes?
A. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client safety initiatives
B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization
C. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
D. Nurses who strike can be legally punished for abandonment and negligence, considered to be professional misconduct
C. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
Rationale: Nurses are client advocates and promotion of professionalism is valued as evidenced by the public’s opinion related to honesty and professionalism
A novice nurse asks about the difference between mediation and binding arbitration. The response should be based on which statement?
A. Mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor
B. Binding arbitration is a formal discussion between labor and management in which the arbitrator’s recommendations are compulsory
C. Mediation uses a trained person to negotiate a legally binding plan
D. Binding arbitration requires both labor and management to participate in discussions on the least destructive approach to allow self-governance by employees
B. Binding arbitration is a formal discussion between labor and management in which the arbitrator’s recommendations are compulsory
Rationale: binding arbitration requires that both parties meet in formal talks, and all parties must obey the arbitrator’s recommendations
A large corporation employs nurses all over the United States. Nurses in one agency learned that fellow nurses in another agency are striking because they are required to work 16-hour shifts to cover for nurses who have left due to unsafe staffing practices. The union of the non-striking agency nurses decides to stop work to support the nurses who are striking. Which statement describes this action?
A. It is placing nurses at risk for a lawsuit because their direct employer did not cause the strike
B. The union in question must be an industry union representing both parties
C. The nurses are participating in a sympathy strike, which, if done correctly, is legal
D. The striking nurses must pay for any losses incurred by the agency during the strike
C. The nurses are participating in a sympathy strike, which, if done correctly, is legal
Rationale: A sympathy strike occurs when a union stops work to support the strike of another union. None of the other options accurately describe the presented situation
Which organization is the largest union in the United States representing registered nurses?
A. American Nurses Association
B. United American Nurses
C. National Nurses United
D. National Labor Relations Board
C. National Nurses United
Rationale: In 2009, the National Nurses United became the largest union representing nurses as a result of a merger between the United American Nurses, California Nurses Association. National Nurses Organizing Committee, and Massachusetts Nurses Association
A nurse is interested in working in a large trauma center that is unionized but doesn’t want to join the union or pay fees. The nurse is not required to join or pay fees to the union based on which law?
A. National Labor Relations Act
B. Right-to-work law
C. National Labor Relations Act
D. Taft-Hartley Act
B. Right-to-work law
Rationale: The right-to-work law prohibits membership or payment of union dues or fees a condition of employment, either before or after hiring
A group of nurses are assembling outside a hospital protesting the use of foreign nurses after several nurses were terminated due to what the hospital called recurring “decreased census”. The nurses carry signs with messages asking potential patients to seek care elsewhere. The local newspaper picked up the story, and the hospital is receiving negative press. The nurses are participating in what action?
A. Picketing
B. Collective bargaining
C. Striking
D. Arbitration
A. Picketing
Rationale: Picketing is a form of protest in which people (called picketers) congregate outside a place of work or location where an event is taking place. Often this is done to dissuade others from going in (“crossing the picket line”), but it can also be done to draw public attention to a cause
A hospital is seeking a 2.5% wage reduction for all nurses as part of a new balanced budget plan; however, the plan provides for raises for upper-level management. This plan resulted in a call for a union to protect the nurses. When the union representative arrives, what questions should the nurse ask? SATA.
A. Will the dues be used to support charity care when clients are unable to pay?
B. How effective has the union been in representing nurses’ best interest?
C. What percent of dues pays union personnel salaries?
D. Are dues used to promote research for terminally ill clients?
E. If arbitration is unsuccessful and a strike occurs, will nurses receive compensation during the strike?
B. How effective has the union been in representing nurses’ best interest?
C. What percent of dues pays union personnel salaries?
E. If arbitration is unsuccessful and a stroke occurs, will nurses receive compensation during the strike?
Rationale: Laborers (staff nurses) want a union with a successful track record of improving wages and benefits. Union dues are used to support union personnel, and the amount varies among different union groups; the higher the percentage of money that goes to pay union personnel salaries, the less money will be available to support members. Employers are not obligated to pay laborers during a strike, and unions may choose to pay employees while striking
During the pre-election phase for unionization, which actions by union representatives are prohibited by the National Labor Relations Board? SATA.
A. Scheduling a meeting in the agency’s cafeteria to determine employees’ interest in unionization
B. Distributing non-documented information that female nurses receive lower annual performance evaluations that do male nurses
C. Distributing information about the benefits of unionization and grievances in a public parking garage located across from the hospital
D. Suggesting to workers the likelihood of job loss should the union not win the election
E. Signing authorization cards for employees who are on leave
A. Scheduling a meeting in the agency’s cafeteria to determine employees’ interest in unionization
B. Distributing non-documented information that female nurses receive lower annual performance evaluations that do male nurses
D. Suggesting to workers the likelihood of job loss should the union not win the election
E. Signing authorization cards for employees who are on leave
Rationale: Union representatives must meet in non-work areas. Union representatives must not spread rumors of prejudices. Neither the union nor employees can spread falsehood about potential job loss or repercussion in the event of unionization. Union representatives cannot sign cards for employees
It is important to realize that nurses may seek unionization if what situation occurred? SATA.
A. Physicians rotate on-call coverage among group members for complication long-term clients
B. Adequate staffing is provided on holidays by rotation of time off for holidays among nurses
C. Incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from their prior shift have left the unit
D. Physicians, nurses, nutritionists, and physical therapists visit concurrently with clients to plan care
E. Staff development activities are planned daily at 8 AM for two consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns
C. Incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from their prior shift have left the unit
E. Staff development activities are planned daily at 8 AM for two consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns
Rationale: Policies where shift reports are taped and heard after a prior shift has left have proved to lead to errors and unsafe care. Staff development activities should be scheduled to allow nurses to attend, and normal staffing patterns or time of training must coincide with nurses’ availability and ability to listen to and retain information (such as at the beginning or end of the shift while others provide coverage)
Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. During the pre-election period, what actions by management are prohibited? SATA.
A. Seek individuals to spy on coworkers who are possible union supporters
B. Photograph employees participating in information sessions about unionization
C. Visit managers outside work to gain their perception of popularity of unionization
D. Threaten that, should the union win, the company will relocate when there is no intention to relocate
E. Require employees to declare their position on unionization prior to pick up paychecks
A. Seek individuals to spy on coworkers who are possible union supporters
B. Photograph employees participating in information sessions about unionization
D. Threaten that, should the union win, the company will relocate when there is no intention to relocate
E. Require employees to declare their position on unionization prior to pick up paychecks
Rationale: During the pre-election period, management may not solicit spying. During the pre-election period, management may not photograph employees engaged in union activities. During the pre-election period, management may not lie about what will happen if the union is the victor in an election. During the pre-election period, management may not question employees about their preferences regarding union activity
A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on the passage of the bill?
A. Explain the rationale for the bill to the school board
B. Contact the elected representative’s office by telephone to request support for the bill
C. Support a health advocate to run for election as state representative
D. Tell all students about the bill
B. Contact the elected representative’s office by telephone to request support for the bill
Rationale: Telephone calls are an effective means of communicating your support for a bill, next to a face-to-face meeting; ask to speak to the staff person assigned to the bill or issue for which the call is being made. After introducing yourself, give a brief and simple message such as, “Please tell senator/representative (name) that I support (bill number)”
Time is becoming crucial for the nurse to address issues related to sponsoring programs to include nearing aid costs as part of Medicare coverage. The nurse involved in grassroots political actions realizes that the least timely method of reaching elected officials would be via what route?
A. Letter
B. Telephone
C. Email
D. Facsimile (fax)
A. Letter
Rationale: Sending letters is the least timely mode by which to communicate with elected officials; because of the anthrax decontamination process that is now in place, delivery of U.S. mail to Congress and to the White House may be delayed by as long as 3 months, making letters an inefficient means of communicating with policymakers
A nurse would like to advocate for increased protective services and reporting mechanisms for elder abuse and attends the “meet the candidate” session at the town hall meeting. This is an important time for the nurse to implement what action?
A. Educating the public’s about the nurse’s political platform
B. Being spontaneous and not deliver a rehearsed speech
C. Addressing the person as “candidate” rather than using a first name that implies a working relationship
D. Learning what the key issues are in the candidate’s platform
D. Learning what the key issues are in the candidate’s platform
Rationale: Town hall gatherings with nurses allow the candidate to talk about his or her platform to a group of interested voters and afford nurses an opportunity to understand the candidate’s vision and to voice their opinions and concerns about health care issues
A nurse would like to obtain background information and learn the political platform of a candidate who is running for national office. The nurse should contact what organization?
A. National Registry for Candidates
B. American Nurses Association Nurses
C. National League of Nurses
D. National Council of State Boards of Nursing
B. American Nurses Association Nurses
Rationale: Through legislative updates, American Nurses Association Nurses Action center keeps members up-to-date about background information and the platforms of candidates who are running for national office and also provides updates about key bills as they move through the legislative process
Political action committees (PACs) are established for what purpose?
A. Financially supporting candidates
B. Persuading policymakers to support certain policies
C. Lobbying legislators
D. Recommending health care policy
B. Persuading policymakers to support certain policies
Rationale: A PAC is an arm of an organization, association, or labor union that is formed to persuade a policymaker to support a certain policy or program or, more often, to ensure the election or re-election of policymakers who support the organization’s goals
When the policy process is compared with the nursing process, identifying the issue is consistent with which step of the nursing process?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
B. Diagnosis
Rationale: The diagnosis step in the nursing process is consistent with identification of the targeted issue in the political process. As politically active nurses soon discover, effective involvement in policy development and political activities requires efforts similar to those used in the nursing process. The policy process and the nursing process are systematic approaches that use the nursing process for decision making
It is important for nurses to know the functions of the branches of the federal government. At a local meeting of the state nurses’ association, an officer reminds members that the branch that can originate major policy initiatives is the _____ branch.
A. Executive
B. Legislative
C. Judicial
D. Administrative
B. Legislative
Rationale: The legislative branch possesses the sole federal power to enact legislation; the legislative branch originates and promotes major policy initiatives and has the power to override a presidential veto
A concerned nursing student calls the office of an elected official to voice support for the bill to ban smoking in all public places. The secretary asks, “Are you a constituent?” What does the term constituent mean?
A. A member of a professional organization who supports the organization’s political issue
B. A citizen who is registered and is eligible to vote for a representative
C. An elected official who proposes legislation to be considered as a potential law
D. A member of the House of Representatives who is seeking support for a particular bill
B. A citizen who is registered and is eligible to vote for a representative
Rationale: A constituent is a citizen who can vote for candidates in elections for representations at local, state, and federal government levels
A person who is covered by Medicaid moves from one state to another and asks the nurse at the health department why the benefits changed. What is the nurse’s correct responses?
A. “Local government controls which benefits each county can provide to Medicaid recipients.”
B. “The federal government doesn’t fund any part of Medicaid, so each state must find ways to pay for benefits”
C. “Each state determines benefits on the basis of the present economy”
D. “Medicaid is funded by both state and federal governments, but benefits vary from state to state”
D. “Medicaid is funded by both state and federal governments, but benefits vary from state to state”
Rationale: Medicaid is a program that is funded through a combination of state and federal funds; thus, benefits vary from state to state
Throughout the history of health care in our nation, one particular piece of federal legislation provided funds for hospital construction. As the number of hospitals rapidly increased, the need for nurses to staff hospitals also increased, and the shift from community-based nursing care to hospital-based nursing care began. What fundamental piece of legislation was the basis of this action?
A. Sheppard-Towner Act
B. Hill-Burton Act
C. Veterans Bill
D. Access to Health Care Bill
B. Hill-Burton Act
Rationale: The Hill-Burton Act, also known as the Hospital Survey and Construction Act, was enacted in 1950. This act provided funding that resulted in a boom in the construction of hospitals across the country. As the number of hospitals increased rapidly, so did the need for nurses to staff the hospitals. Thus the nurse’s role was shifted from community and public health settings to the acute care setting
