PATIENT CARE ISSUE, EMPLOYMENT ISSUE, MANAGEMENT ISSUE, MEDICO-LEGAL ISSUE

3. A study conducted in 1991 in 119 countries
including India identified following major
problem:-
 Lack of nurses prepares to work in nursing
administration.
 Acute storage of nurses.
 Less relationship between nursing service
and nursing education.

4.  Lack of authority in administrative structure.
 Strange relationship between nurses and
other auxiliaries and also with physicians.
 Lack of teamwork spirit.
 Lack of resources, both material and
financial.

5.  Restructuring.
 Managed care system
 Quality indicators and accountability for outcomes.
 New demands/ technology advancement.
 High tech and high touch dilemma.
 Community/ global perspective.

6.  Identity Crisis
 Explain Everything
 Language Barrier
 Constant Interruptions
 Patient Concerns

7.  Volume Control
 Hospital Nurse Staffing and
Nursing-Sensitive Outcomes
 Nurse Workload and
Job Dissatisfaction

8.  MATERNAL AND
INFANT NURSING.
 PEDIATRIC NURSING.
 MEDICAL SURGICAL NUSING.
 PSYCHIATRIC NURSING.

9.  Employment issues are defined as any
issue which may have an impact on
wages, terms and other conditions of
employment.

10.  Delays in registration
 Employment discrimination
issues
 Employment harassment issues
 Mandatory Overtime
 Job dissatisfaction

11.  Employment occupational health
and safety issues.
 Employment retention
& turnover issues
 Employment performance
appraisal issues
 Employment recruitment
& selection issues

12.  Issue related to staffing
 Staff retention
 Nursing Shortages
 Demand for nurses

13.  Turn over
 Work load
 Issues regarding malpractice in nursing
management
 Collaboration issues

14.  Controlled substances
 Caring patients with AIDS
 Pregnancy Termination
 Sex determination

15.  Abscond of the patient
 Deaths and dying
 Autopsy and organ
donation
 Surrogate mother

16.  Advance directives.
 Do not resuscitate
(DNR) order.
 Patient’s property.
 Reporting.

17.  Documentation of all unusual
incidences.
 Report all unusual incidences.
 Know your job description.
 Follow policies and procedures as
established by your employing agency.
 Keep your registration updated.
 Perform procedures that you have been
taught and that are within the standard
scope of your practice.

18.  Protect patients from injuring
themselves.
 Remain alert and focused.
 Establish and maintain rapport with
patients and family.
 Seek and clarify orders when the
patient‘s medical condition changes.
 Practice safety with physician‘s verbal
orders.

19.  Remove side rails from patient‘s bed unless
there is an order or hospital policy to do so.
 Allow patients to leave the hospital or
nursing home unless there is an order or a
signed release.
 Accept money or gifts from patients.
 Give advice that is contrary to physician
orders or the nursing care plan.

20.  Give medical advice to friends and
neighbors.
 Attempt to practice medicine.
 Witness a patient‘s will.
 Take medications that belong to
patients.
 Worked as a licensed
practical/vocational nurse in a state
in which you are not licensed.

23. Bibliography:
•Vati Jogindra. Principles and Practice of Nursing
Management and Admistration. 1st edition: Jaypee
Brothers Medical Publishers (P) Ltd. New Delhi; 2013. Pp
85-91.
•Basavanthappa BT. Nursing Education. 2nd edition: Jaypee
Broers Medical Publishers. New Delhi; 2009.pp 809-836.
•Fraser M. Diane. Margaret A. Cooper. Myles Textbook for
Midwives. 14th ed: Churchill Livingstone New York Oxford
Philadelphia Publishers.Toronto; 2003. pp 59- 69.
•http://www.nursingworld.org
•www.ncbi.nlm.nih.gov
•http://allnurses.com
•http://nursinglink.monster.com
•http://www.nursingcenter.com