Nursing Practice Meets Theory

These are challenging times for nurse leaders. Over the last decade, debates on healthcare reform have focused on the cost of care in the United States. This discussion has placed increasing pressure on nurse leaders to operate organizations that are more efficient, while improving quality and patient outcomes. The practice of commanding and directive leadership has never been effective long term. Nurses want leaders to make sense of a situation and explain the why. With the growing trend toward hospital reimbursement for performance measures that are nurse-driven and informed consumers with higher expectations than ever before, it is vital that nurse leaders help nurses reconnect to their purpose in order to obtain these goals. A large, integrated, not-for-profit healthcare system in the Northern California (NCAL) region witnessed a decrease in their Hospital Compare Assessment of Healthcare Providers and Systems (HCAHPS) summary star rating. Despite the significant financial investments to improve patient satisfaction, this healthcare system was not seeing the benefits. The intent of this project was to actualize Jean Watson’s human caring theory, support care experience best practices that promote patient satisfaction, and transform cultural norms that move the caring theory from a conceptual level to an operational level in a small urban hospital. “It is hoped that some level of this work will help us all, in the caring-healing profession, to remember who we are and why we have come here to do this work in the world” (Watson, 2008, p. 41). Outcomes were an improvement in summary star of 2.8 to 3.1 within three months of implementation of this project within the identified facility and sustained for 15 months, despite significant turnover in nursing leadership. Next steps will be to spread this project region-wide to continue to improve the organizational overall summary star rating

Employers\u27 Garnishment Policies - Do They Engender Racial Discrimination in Violation of Title VII and the Civil Rights Act of 1866?

This note evaluates the hypothesis that employment policies which mandate suspension or discharge for multiple garnishments are racially discriminatory. It considers the methods of challenge such as a claim under Title VII of the Civil Rights Act of 1964, the lack of consensus between the courts and the Equal Employment Opportunity Commission (EEOC), and also emerging issues. The note finds that the legality of employment practices imposing disciplinary action against garnished employees is left uncertain. Proof of a disproportionate effect on minorities employees may be adequate, although a satisfactory showing of business necessity may be a defense against a claim of a Title VII violation. What constitutes a satisfactory showing of business necessity varies by jurisdiction but the note concludes that with the trend towards finding such practices racially suspect, employers should reconsider their policies

Employers\u27 Garnishment Policies - Do They Engender Racial Discrimination in Violation of Title VII and the Civil Rights Act of 1866?

This note evaluates the hypothesis that employment policies which mandate suspension or discharge for multiple garnishments are racially discriminatory. It considers the methods of challenge such as a claim under Title VII of the Civil Rights Act of 1964, the lack of consensus between the courts and the Equal Employment Opportunity Commission (EEOC), and also emerging issues. The note finds that the legality of employment practices imposing disciplinary action against garnished employees is left uncertain. Proof of a disproportionate effect on minorities employees may be adequate, although a satisfactory showing of business necessity may be a defense against a claim of a Title VII violation. What constitutes a satisfactory showing of business necessity varies by jurisdiction but the note concludes that with the trend towards finding such practices racially suspect, employers should reconsider their policies

Preemption of State Spam Laws by the Federal Can-Spam Act

Unsolicited bulk commercial email is an increasing problem, and though many states have passed laws aimed at curbing its use and abuse, for several years the federal government took no action. In 2003 that changed when Congress passed the CAN-SPAM Act. Though the law contains many different restrictions on spam messages, including some restriction of nearly every type that states had adopted, the Act was widely criticized as weak. Many of the CAN-SPAM Act\u27s provisions are weaker than corresponding provisions of state law, and the Act preempts most state spam laws that would go farther, including two state laws that would have banned all spam. Despite these weaknesses, this Comment argues that when properly interpreted the CAN-SPAM Act leaves key state law provisions in force, and accordingly is stronger than many spam opponents first thought. First, the law explicitly preserves state laws to the extent that they prohibit falsity or deception in any portion of a commercial electronic mail message or information attached thereto. Though Congress was primarily concerned with saving state consumer protection laws, this language can be applied much more broadly. Second, the law is silent on the question of state law enforcement methods. State enforcement can be, and frequently is, substantially stronger than federal enforcement, which is largely limited to actions by the federal government, internet service providers, and state agencies. The Comment concludes by arguing that this narrow interpretation of its preemption clause is most consistent with the CAN-SPAM Act\u27s twin policy goals. By limiting the substantive provisions states may adopt, the Act prevents states from enacting inconsistent laws and enforces a uniform national spam policy. At the same time, narrowly interpreting the preemption clause permits states to experiment within the limits of that policy, in hopes of finding the most effective set of spam regulations