nurse as an employee

8/13/2019 Nurse as an Employee

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THE NURSE AS INEMPLOYEE


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The Concept of a Professional Employer and Employee

Relationship

The Test for Determining the Existence of an Employer-

Employee Relationship

Rights and Responsibilities of a Nurse

Rights of Nurse-Practioners vis-a-vis Rights of Clients/Patients


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The Constitution of the Philippines provides that the

State shall afford full protection to labor, local and

overseas, organized and unorganized, and promote fullemployment and equality of employment

opportunities for all.

It shall guarantee the rights of all workers to self-

organization, collective bargaining and negotiations,

and peaceful concerted activities, including the right to

strike in accordance with law.


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They shall be entitled to security of tenure, humane

conditions of work, and a living wage. They shall also

participate in policy and decision-making processes

affecting their rights and benefits as may be provided by

law.


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There must be an employer-employee relationship in order

for the provisions of the Labor Code on the Labor Standards

to apply.

It follows that an individual who renders service outside of

the ambit of an employer-employee relationship is not

within the coverage of the statutory benefits or laborstandards of the Philippine Labor Code; hence, commercial

transactions (such as partnership, independent contracts,

co-ownership, self-employment, etc.) are beyond the scope

of the Labor Code.


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EMPLOYER

A legal entity that controls and directs a servant

or worker under an express or implied contract of

employment and pays(or is obligated to pay) him or

her salary or wages in compensation.


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EMPLOYEE

A person who is hired to provide services to

a company on a regular basis in exchange for

compensation and who does not provide these services

as part of an independent business.


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When an employer hires a new employee, he is not just

bringing a new member of the workforce aboard, he is also

starting a new relationship. Because employers and

employees often work in close quarters, they necessarilydevelop relationships.

Managing these relationships is vital to business success, as

strong relationships can lead to greater employee happinessand even increased productivity. To reap these benefits, keep

the dynamics of your employer-employee relationship in

mind.


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Relationship Basics

Generally, employer and employee relationships should be

mutually respectful. The degree of closeness in theserelationships will depend on both the employer and the

employee.

Some employers opt to keep their employees at a distanceand, in doing so, ensure that there is no confusion as to the

hierarchy that exists between them.


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Others elect to become friendlier with their employees,seeing this as a way to amp up employee happiness.

While neither option is entirely right or wrong, it is wise

to avoid getting too close to employees, as doing so can

cause the line between employer and employee to

become blurred


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Mutual Reliance

The employer-employee relationship should be one

of mutual reliance. The employer is relying upon the

employee to perform her job and, in doing so, keep

the business running smoothly.

Conversely, the employee is relying upon theemployer to pay her and enable her to support

herself, and potentially her family, financially.


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Relationship Building

Just as with all relationships, the employer and employeerelationship is one that must develop over time.

Employers can promote the building of relationships by

speaking candidly with their employees about their lives,

asking them about their families and learning about theirinterests.

Similarly, employees can promote the building of this

relationship by being open with their employer andsharing information about themselves and their lives.


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Boundaries

Though the type of employee and employer relationship that

is considered appropriate varies from company to company,

boundaries exist at almost all companies.

Generally, it is unwise for employers to develop romantic

relationships with their employees. Similarly, employersshould exercise care to ensure that the relationship they

develop with one employee isn't notably closer than the

relationships they develop with others, as this can lead to

concerns regarding favoritism or similar issues of unfairnesswithin the workplace.


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When can we say that an individual is considered as

an employee?

How can he prove that he is working for a certain

employer?


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Tests to Determine the Existence of

an EmployerEmployee

Relationship


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FOUR FOLD TEST

This test determines the existence of an employer - employeerelationship

1. Whether the alleged employer has the power of

selection and engagement of the employee (Power to

Hire)

Engagement means a contract within the business and

affiliations; Which means if there is a problem within the

vicinity of the employee it will be engaged to the employer,the same if there is a problem with the employer, changes will

be engaged to the employees.


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2. Whether the employee is being paid wages (Power to

pay wages)

Changes with the salary made by the employer must be

distributed well to all the employees; All employees means

the employer cant disregard any employee within hiscompany.


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3. Whether he has the power to dismiss

(Power to Discipline)

The employer has to power to dismiss, punish or

reprimand any employee, only if the employer has full

accountability and knowledge of the misconduct or

unprofessionalism of the employee.


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4. Whether he has control of the employee with respect to

the means and methods by which work is to be

accomplished (Power of Control)

The employer has the power to control his or her employees

by any means and methods he wants to accomplish the

companies goal, even if the way he wants it is time

consuming, it is the employers right.


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Economic Reality Test

In Sevilla v. Court of Appeals, the Court observed the need to

consider the existing economic conditions prevailing between the

parties, in addition to the standard of right-of-control, to give a

clearer picture in determining the existence of an employer-

employee relationship based on an analysis of the totality of

economic circumstances of the worker.


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Under economic reality test, the benchmark in analyzing

whether employment relation exists between the parties is the

economic dependence of the worker on his employer. That is,whether the worker is dependent on the alleged employer for

his continued employment in the latters line of business.

Applying this test, if the putative employee is economically

dependent on putative employer for his continued employment

in the latters line of business, there is employer-employee

relationship between them. Otherwise, there is none.


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Two-tiered test (or Multi-factor test)

The economic reality test is not meant to replace the right of control

test. Rather, these two test are often use in conjunction with each

other to determine the existence of employment relation between

the parties. This is known as the two-tiered test, or multi-factor test.

This two-tiered test involves the following tests:

The putative employers power to control the employee with respect

to the means and methods by which the work is to be accomplished;

and The underlying economic realities of the activity or relationship.


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The determination of the existence of employer-

employee relation must be tilted in favor of the

employee since any doubt in the interpretation of

the provision of the Labor Code shall be construed in

favor of labor.


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The determination of the existence of an

employer-employee must follow, not only becauseof the statutory provision but by humanitarian

reason as the employee is almost or most of the

time at the disadvantage situation and the law

must protect the disadvantaged.


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Nurse

A person educated and trained to care for the sick or disabled.

A woman employed to take care of a child; a nursemaid.

A woman employed to suckle children other than her own; awet nurse.

One that serves as a nurturing or fostering influence or means:

The American Heritage Dictionary of the English Language, Fourth Edition copyright 2000 by Houghton

Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.
http://www.eref-trade.hmco.com/http://www.eref-trade.hmco.com/


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Nursing encompasses autonomous and collaborative care ofindividuals of all ages, families, groups and communities, sick

or well and in all settings. It includes the promotion of

health, the prevention of illness, and the care of ill, disabled

and dying people.

World Health Organization


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ROLES AND RESPONSIBILITIESOF A NURSE


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1. Caregiver/ Care provider

The traditional and most essential role functions as nurturer,

comforter, provider mothering actions of the nurse, it also

provides direct care and promotes comfort of client, provide

activities involves knowledge and sensitivity to what matters

and what is important to clients and shows concern for client

welfare and acceptance of the client as a person


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2. Teacher

Provides information and helps the client to learn or acquire

new knowledge and technical skills, the nurse also

encourages compliance with prescribed therapy, promotes

healthy lifestyle and interprets information to the client


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3. Counselor

Helps client to recognize and cope with stressful psychologic or

social problems; to develop an improve interpersonal

relationships and to promote personal growth

provides emotional, intellectual to and psychologic support.

It focuses on helping a client to develop new attitudes, feelingsand behaviors rather than promoting intellectual growth.

Encourages the client to look at alternative behaviors recognize

the choices and develop a sense of control.


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4. Client advocate

Involves concern for and actions in behalf of the client to bringabout a change.

Promotes what is best for the client, ensuring that the clients

needs are met and protecting the clients right.

Provides explanation in clients language and support clients

decisions.


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5. Manager

Makes decisions, coordinates activities of others, allocateresources, evaluate care and personnel plans, give direction,

develop staff, monitors operations, give the rewards fairly and

represents both staff and administrations as needed .


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6. Researcher

Participates in identifying significant researchable problems,

in scientific investigation and must be a consumer of research

findings

Researcher must be aware of the research process, language

of research, a sensitive to issues related to protecting therights of human subjects.


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7. Change agent

Initiate changes or assist clients to make modifications inthemselves or in the system of care.


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8. Clinical Specialists

Is a nurse who has completed a masters degree in specialty andhas considerable clinical expertise in that specialty.

She provides expert care to individuals, participates in educating

health care professionals and ancillary, acts as a clinicalconsultant and participates in research.


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9. Nurse Practitioner

Is a nurse who has completed either as certificate program or amasters degree in a specialty and is also certified by the

appropriate specialty organization.

She is skilled at making nursing assessments, performing P. E.,

counseling, teaching and treating minor and self- limiting

illness


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10. Nurse-midwife

A nurse who has completed a program in midwifery;provides prenatal and postnatal care and delivers babies to

woman with uncomplicated pregnancies.

11. Nurse Educator

A nurse usually with advanced degree, who beaches in

clinical or educational settings, teaches theoretical

knowledge, clinical skills and conduct research.


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12. Nurse Entrepreneur

A nurse who has an advanced degree, and manages

health-related business.

13. Nurse administrator

A nurse who functions at various levels of management

in health settings; responsible for the management and

administration of resources and personnel involved in

giving patient care.


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NURSES RIGHTSVenzon, Lydia M. RN, MAN, PhD, FPCHA; Venzon, Ronald M., RN, MAN Professional

Nursing in the Philippines(2010) 11 The edition chapter 8 page 108


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1. Nurses have the right to practice in a manner that fulfills

their obligations to society and to those who receive

nursing care.

2. Nurses have the right to practice in environment that allow

them to act in accordance with professional standards and

legally authorized scopes of practice.

3. Nurses have the right to a work environment that supports

and facilitates ethical practice, in accordance with theCode of Ethics for Nurses and its interpretive statements.


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4. Nurses have the right to freely and openly advocate for

themselves and their patients, without fear or retribution.

5. Nurses have the right to fair compensation for their work

consistent with their knowledge, experience, and professional

responsibilities.

6. Nurses have the right to a work environment that is sale for

themselves and their patients.

7. Nurse have the right to negotiate the conditions of their

employment, either as individuals or collectively, in all practice

settings


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Rights of Patients

Philippine Patients Bill of Rights


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1. Right to Appropriate Medical Care and Humane Treatment.

Every person has a right to health and medical care correspondingto his state of health, without any discrimination and within the

limits of the resources, manpower and competence available for

health and medical care at the relevant time.

The patient has the right to appropriate health and medical care

of good quality.


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In the course of such care, his human dignity, convictions,

integrity, individual needs and culture shall be respected.

If any person cannot immediately be given treatment that is

medically necessary he shall, depending on his state of health,

either be directed to wait for care, or be referred or sent for

treatment elsewhere, where the appropriate care can

be provided.


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If the patient has to wait for care, he shall be informed of the

reason for the delay.

Patients in emergency shall be extended immediate medical care

and treatment without any deposit, pledge, mortgage or any form

of advance payment for treatment


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2. Right to Informed Consent.

The patient has a right to a clear, truthful and substantial

explanation, in a manner and language understandable to the

patient, of all proposed procedures, whether diagnostic, preventive,

curative, rehabilitative or therapeutic, wherein the person who will

perform the said procedure shall provide his name and credentials to

the patient, possibilities of any risk of mortality or serious sideeffects, problems related to recuperation, and probability of success

and reasonable risks involved:

:


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The patient will not be subjected to any procedure without

his written informed consent, except in the following cases

A. Emergency cases where death is a big risk in thesituation.

B. When controlling an epidemic that may pose risk to

community.

C. When a law make is compulsory for everyone

D. When a patient is a minor or legally incompetent; third

party is required


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E. When disclosure of material information to patient will

jeopardize the success of treatment, in which case, third

party disclosure and consent shall be in order.

F. When the patient waives his right in writing.


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Informed consent shall be obtained from a patient concerned

if he is of legal age and of sound mind. In case the patient is

Incapable of giving consent and a third party consent is required,the following persons, in the order of priority stated here under,

may give consent:

1. Spouse

2. Son or daughter of legal age

3. Either parent

4. Brother or sister of legal age

5. Guardian


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3. Right To Privacy and Confidentiality.

The privacy of the patients must be assured at all stages of his

treatment. The patient has the right to be free fromunwarranted public exposure, except in the following cases:

1. When his mental or physical condition is in controversy and

the appropriate court, in its discretion, orders him to submit

to a physical or mental examination by a physician.

2. When the public health and safety so demand

3. When the patient waives this right


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The patient has the right to demand that all information,

communication and records pertaining to his care be treated

as confidential.

Any health care provider or practitioner involved in the

treatment of a patient and all those who have legitimate

access to the patient's record is not authorized to divulge anyinformation to a third party who has no concern with the care

and welfare of the patient without his consent, except:


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Informing the spouse or the family to the first degree of the

patients medical condition may be allowed; Provided, That the

patient of legal age shall have the right to choose on whom to

inform.

In case the patient is not of legal age or is mentally incapacitated,

such information shall be given to the parents, legal guardian or

his next of kin.

4 Ri h I f i


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4. Right to Information.

In the course of his/her treatment and hospital care, the patient or

his/her legal guardian has a right to be informed of the result of theevaluation of the nature and extent of his/her disease, any other

additional or further contemplated medical treatment on surgical

procedure or procedures, including any other additional medicines

to be administered and their generic counterpart including

the possible complications and other pertinent facts, statistics or

studies, regarding his/her illness, any change in the plan of care

before the change is made, the persons participation in the plan of

care and necessary changes before its implementation, the extent

to which payment maybe expected from Philhealth or any pay orand any charges for which the patient maybe liable, the disciplines

of health care practitioners who will furnish the care and the

frequency of services that are proposed to be furnished

5 The Right To Choose Health Care Provider and Facility


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5. The Right To Choose Health Care Provider and Facility.

The patient is free to choose the health care provider to

serve him as well as the facility except when he is under the

care of a service facility or when public health and safety so

demands or when the patient expressly or impliedly waives

this right.

The patient has the right to discuss his condition with aconsultant specialist, at the patients request and expense.

He also has the right to seek for a second opinion and

subsequent opinions, if appropriate, from another healthcare provider/practitioner.

6 Ri ht t S lf D t i ti


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6. Right to Self-Determination.

The patient has the right to avail himself/herself of any

recommended diagnostic and treatment procedures.

Any person of legal age and of sound mind may make an advance

written directive for physicians to administer terminal care when

he/she suffers from the terminal phase of a terminal illness:

Provided, That

a)He is informed of the medical consequences of his choice;

b)He releases those involved in his care from any obligation relativeto the

consequences of his decision;

c)His decision will not prejudice public health and safety.


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7. Right to Religious Belief.

The patient has the right to refuse medical treatment

or procedures which may be contrary to his religious beliefs,subject to the limitations described in the preceding

subsection: Provided,

That such a right shall not be imposed by parents upon theirchildren who have not reached the legal age in a life

threatening situation as determined by the attending

physician or the medical director of the facility

8 Ri ht t M di l R d


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8. Right to Medical Records.

The patient is entitled to a summary of his medical history and

condition, He has the right to view the contents of his medicalrecords, except psychiatric notes and

other incriminatory information obtained a bout third parties,

with the attending physician explaining contents thereof.

At his expense and upon discharge of the patient, he may

obtain from the health care institution a reproduction of the

same record whether or not he has fully settled his financial

obligation with the physician or institution concerned.


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The health care institution shall issue a medical certificate to the

patient upon request.

Any other document that the patient may require for insurance

claims shall also be made available to him within a reasonable

period of time.


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9. Right to Leave

The patient has the right to leave a hospital or any other health

care institution regardless of his physical condition: Provided,That

a) he/she is informed of the medical consequences of his/her

decision;

b) he/she releases those involved in his/her care from any

obligation relative to

the consequences of his decision;

c) his/her decision will not prejudice public health and safety.

No patient shall be detained against his/her will in any healthcare institution on the sole basis of his failure to fully settle is

financial obligations.


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10. Right to Refuse Participation in Medical Research.

The patient has the right to be advised if the health care

provider plansto involve him in medical research, including but not

limited to human experimentation which may

be performed only with the written informed consent

of the patient.


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11. Right to Correspondence and to Receive Visitors

The patient has the right to communicate with relatives and

other persons and to receive visitors subject to reasonablelimits prescribed by the rules and regulations of the health

care institution

12 Ri h E G i


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12. Right to Express Grievances.

The patient has the right to express complaints and grievances

about the care and services received withoutfear of discrimination or reprisal and to know about the

disposition of such complaints.

The Secretary of Health, in consultation with health care

providers, consumer groups and other concerned agencies

shall establish a grievance system wherein patients may seek

redress of their grievances.

Such a system shall afford all parties concerned with theopportunity to settle amicably all grievances

13 Right to be Informed of His Rights and Obligations as a


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13. Right to be Informed of His Rights and Obligations as a

Patient.

Every person has the right to be informed of his rights andobligations as a patient. The Department of Health, in

coordination with health

care providers, professional and civic groups, the media, health

insurance corporations, peoples organizations, local government

organizations, shall launch and sustain a nationwide information

and education campaign to make

known to people their rights as patients, as declared in this Act.

Such rights & obligations of patients shall be posted in a bulletinboard conspicuously placed in a health care institution.

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Francisco vs. NLRC, G.R. No. 170087 August 31, 2006

Religious of the Virgin Mary vs. NLRC, G.R. No. 103606,

October 13, 1999

Viaa vs. Al-Lagadan and Piga, 99 Phil. 408 (1956).

Sevilla v. Court of Appeals, G.R. Nos. L-41182-3, April 15,1988.
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