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You are a unit supervisor in a skilled nursing facility. One of your aides, Martha Greenwald, recently reported that she suffered a “back strain” several weeks ago when she was lifting an elderly patient. She did not report the injury at the time because she did not think it was serious. Indeed, she finished the remainder of her shift and has performed all of her normal work duties since that time. Today, Martha reports that she has just left her physician’s office and that he has advised her to take 4 to 6 weeks off from work to fully recover from her injury. He has also prescribed physical therapy and electrical nerve stimulation for the chronic pain. Martha is a relatively new employee, so she has not yet accrued enough sick leave to cover her absence. She asks you to complete the paperwork for her absence and the cost of her treatments to be covered as a work-related injury. When you contact the workers’ compensation case manager for your facility, she states that the claim will be investigated; however, with no written or verbal report of the injury at the time it occurred, there is great likelihood that the claim will be rejected. ASSIGNMENT:  How best can you advocate for this subordinate?

 

 
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You are an RN case manager for a large insurance company. Sheila Johannsen is a 34-year-old mother of two small children. She was diagnosed with advanced, metastatic breast cancer 6 months ago. Traditional chemotherapy and radiation seem to have slowed the spread of the cancer, but the prognosis is not good. Sheila contacted you this morning to report that she has been in contact with a physician at one of the most innovative medical centers in the country. He told her that she might benefit from an experimental gene therapy treatment; however, she is ineligible for participation in the free clinical trials since her cancer is so advanced. The cost for the treatment is approximately $150,000. Sheila states that she does not have the financial resources to pay for the treatment and begs you “to do whatever you can to get the insurance company to pay. Otherwise, she will die.” You know that the cost of experimental treatments is almost always disallowed by your insurance company. You also know that even with the experimental treatment, Sheila’s probability of a cure is very small. ASSIGNMENT:  Decide how you will proceed. How can you best advocate for this patient?

 

 
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Recover Inc., a fictitious for-profit home health agency, provides complete nursing and supportive services for in-home care. Services include skilled nursing, bathing, shopping, physical therapy, occupational therapy, meal preparation, housekeeping, speech therapy, and social work. The agency provides round-the-clock care, 7 days a week, to a primarily underserved rural area in northern California. The brochure the company publishes says that it is committed to satisfying the needs of the rural community and that it is dedicated to excellence. ASSIGNMENT: Based on this limited information, develop a brief philosophy statement that might be appropriate for Recover Inc. Be creative, and embellish information if appropriate.

 

 
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The human resource manager in the facility where you are a supervisor has just completed a survey of the potential retirement plans of the nursing staff and found that within 5 years, 45% of the staff will probably be retiring. You know that past and present available statistics show that you normally replace 10% to 20% of your staff each year with new hires. You are concerned, as you do not know how you will be able to handle this new increase in your need for staff. ASSIGNMENT: Make a 5-year, long-term plan that will increase the likelihood of your being able to meet this new demand. Remember that other units within your facility and other healthcare organizations in your region may also be facing the same problem.

 

 
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