chapter 12 | Promoting a Healthy Workplace 189institution, agency, or larger system (ANA, 2001).
The sources of various federal and state guidelines
governing the workplace are listed in Box 12-7.
Protection by the agency should be afforded to
both the accused and the person doing the report-
ing.Whistlebloweris the term used for an employee
who reports employer violations to an outside
agency. Do not assume that doing the right thing
will protect you. Speaking up could get you fired
unless you are protected by a union contract or
other formal employment agreement. In May
1994, the U.S. Supreme Court ruled that nurses
who direct the work of other employees may be
considered supervisors and therefore may not be
covered by the protections guaranteed under the
National Labor Relations Act. This ruling may
cause nurses to have no protection from retaliation
if they report illegal practices in the workplace
(ANA, 1995b). The 1995 brochure from the ANA
(1995a),Protect Your Patients—Protect Your License,
states, “Be aware that reporting quality and safety
issues may result in reprisals by an employer.” Does
this mean that you should never speak up? Case
law, federal and state statutes, and the federal False
Claims Act may afford a certain level of protection.
Some states have whistleblower laws. They usually
apply only to state employees or to certain types of
workers. Although these laws may offer some pro-
tection, the most important point is to work
through the employer’s chain of command and
internal procedures: (a) make sure that whistle-
blowing is addressed at your facility, either through
a collective bargaining contract or workplace advo-
cacy program; (b) contact your state nurses associ-
ation to find out if your state offers whistleblower
protection or has such legislation pending; (c) be
politically active by contacting your state legislators
and urge them to support a pending bill or by edu-
cating your elected state officials on the need
for such protection for all health-care workers; and
(d) contact your U.S. congressional representatives
and urge them to support the Patient Safety Act
(nursingworld.org/tan/98janfeb/nlrbmass).
It is the responsibility of professional nurses
to become acquainted with the state and federal
regulations, standards of practice and professional
performance, and agency protocols and practice
guidelines governing their practice. Lack of knowl-
edge will not protect you from ethical and legal
obligations. Your state nurses association can help
you seek information related to incompetent,
unethical, or illegal practices. When you join your
state association, you will gain access to an organi-
zation that has input into policies and procedures
designed to protect the public.
Although the rights of disabled nurses are not
usually considered “questionable practices,” the
ANA is concerned with those rights. The
Americans With Disabilities Act, enacted in 1990,
makes it unlawful to discriminate against a quali-
fied individual with a disability. The employer is
required to provide reasonable accommodations for
the disabled person. A reasonable accommodation
is a modification or adjustment to the job, work
environment, work schedule, or work procedures
that enable a qualified person with a disability to
perform the job. Both you and your employer may
see information from the Equal Employment
Opportunity Commission (EEOC) for informa-
tion (nursingworld.org/dlwa/wpr/wp6).Terrorism and Other Disasters
Since the attacks on the World Trade Center and
the Pentagon as well as the anthrax outbreaks and
continued terrorist threats nationwide, concerns
related to biological and chemical agents have sur-
faced. The CDC Web site (bt.cdc.gov/) supports
ongoing information related to public health emer-
gency preparedness and response. The ANA has
published a position statement for employers on
work release during a disaster. In addition, the ANA
provides RNs with valuable information on how
they can better care for their patients, protect them-
selves, and prepare their hospitals and communities
to respond to acts of bioterrorism and natural disas-
ters (nursingworld.org/news/disaster/). For example,box 12-7
Laws Governing Health-Care Practices- State nurse practice acts
- Federal and state health regulations
- State and federal pharmacy laws for controlled substances
- OSHA
- State medical records and communicable disease laws
- Environmental laws regulating hazardous waste and air
and water quality - CDC guidelines
- Federal and state antidiscrimination laws
- State clinical laboratory regulations
- JCAHO regulations
Adapted from American Nurses Association. (1994). Guidelines on Reporting
Incompetent, Unethical, or Illegal Practices.Washington, DC: ANA.