Tuesday, August 20, 2013
Exclusions are costly and options can offer a win-win situation where patient safety is at issue.
Nurses undergoing state board discipline are often unable to work during the investigation and disciplinary process which can take a very long time. Unfortunately jobs are not available in other fields to help generate income. Currently, from April to June 2012. the UK unemployment rate is 7.8%.
http://www.NAO.org.uk The National Audit Office (NAO) has reported to Parliament on the cost of exclusions that entails: employment cost of the excluded clinician, cost incurred on staff to cover/replace the excluded clinician, management time related to the administration of the exclusion, including investigations of allegations or events leading up to the exclusion and legal costs. The NAO estimates total gross costs of exclusion across all cases could be fifty seven million pounds. The annual cost associated with excluding clinicians based on average weekly costs and average numbers of excluded clinicians is thirty million. Gross cost associated with clinical exclusions is estimated to be forty million pounds. The speed with which the issue with the clinician is addressed and resolved within six months could be a cost saving measure of fourteen million pounds per year.
Initial investigations and consideration of options (2.12) In the majority of cases patient safety was not at issue and the decision to exclude is sometimes a knee jerk reaction made by trusts without sufficient investigation.
Reasons for exclusions (1.13)
Professional competence (23%) 44% of MDs and (19%) of other clinical staff.
Professional conduct - physical abuse/assault of patients or inappropriate behaviour toward patient(s).
Personal conduct - theft, fraud, ETOH
Number of excluded clinical staff
1,063 clinicians excluded from work at least one month Apr 2001 to July 2002. 206 (20%) consultants/Mds; 567 (53%) nurses and midwives; 290 (27%) allied health professionals.
Key findings A number of exclusions occur as a result of no risk to patients. Were there have been patient safety, incidents, trusts have sometimes excluded clinicians despite evidence of systemic failures rather than individual short comings.
Clinicians commonly experienced delays in clarifying allegations - shifting goal posts and new claims added, as well as limited opportunity to rebut the allegations.
Rachel Murry, University of Manchester Research (2002, 2003) based in grounded theory tells of how nurses felt as a result of the experience. Nurses complained that they had an immediate suspension without preliminary investigation. They perceived the suspension as punitive and was a presumption of guilt. They told the researcher about the manner in which they were suspended caused additional stress as they were not told of the nature of the allegations; told to go straight home and escorted off the premises; banned from the premises; prohibited from contacting colleagues. They felt that they were not supported in any way and did not feel in a fit state to go home by themselves. The nurses perceived unfairness within and between the trusts - inconsistencies, as nurses in similar circumstances were not suspended.
Option (3.20) restriction on clinical practice if there is a need to protect patients and other staff rather than exclusion although this has been implemented in only 2% of all exclusions.
I will write further about how the system is monitored.
Peer review as an option to hiring a lawyer. If you decide to hire a lawyer ask if she/he is CPRJ Certified.
Dr. Richard Willner, The Center for Peer Review Justice has offered to answer questions from nurses for free. You can also call 504-621-1670 24/7. CPRJ, 1000 W. Esplande, Suite 102-105, Kenner, LA 78065, USA
Many nurses read this blog from around the world and I know that you can defend your license if you understand how to respond with the right resources.
As always I will include spirituality as a way of tapping into a higher power and source of energy that will help guide you intuitively through the many changes you will make ahead. Focus on learning from those who can teach you about using the third eye or space between the eyes and concentrate you attention there. Someone recently shared that she has learned many new tools such as this from Scientology and I recommend that you use any of the links I have mentioned thus far and this one also to understand how to tap into your own inner power.
My best wishes are always with you as you become empowered during this difficult time.
You may contact me at lawrencerita511@gmail.com
Rita
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