N108: Transition to the Registered Professional Nurse Role Study Guide rations for all settings. In settings where there is limited RN staffing, other problems that emerge include difficulty obtaining RN coverage for anyone that leaves the unit and overtime issues when there are not enough RNs to cover the needed tasks on the shift. Negligent staffing is the failure to maintain adequate staffing that may result in harm. This is a variation of vicarious liability, which means the organization is responsible for damage to the patients rather than the individual. This can also be called direct corporate liability. The organization represents to patients that they will provide safe care in exchange for the payment of services. Damages may be awarded if harm comes to a patient due to the lack of staff. Individual clinicians and managers should not be liable if they communicate their concerns about proper staffing. They are not held responsible for poor staffing if the harm to the patient is not caused by the clinician’s negligence or the supervisor’s decision to schedule poorly. However, the credentialing board may decide to hold the clinician accountable. Regardless of available staffing, the clinician and the supervisor are liable for any malpractice they personally commit. Clinicians are required to meet the standards of the practice of a reasonably prudent clinician. It is the clinician’s responsibility to communicate any danger to the patient to the level of management who can correct the problem. A clinician must inform administrators of inadequate staffing in writing every time the situation occurs. Supervisors are required to do something with the information including investigation, assessment, or the addition of more staffing. Carrying out doctor’s orders cannot be used as protection from liability. The nurse must carry out only orders that she knows to be appropriate to patient care. Nurses are required to report suspected abuse of dependent coworkers. Most laws that require reporting also protect the nurse for reporting in error if she did so in good faith. This means if a nurse has a reasonable basis for believing abuse is occurring, she should report the abuse without fear of punishment if she is wrong. 2.19 Employment Rights Unionization A union is a legally authorized organization that has been empowered by its members to negotiate and enforce a contract. In order to engage in collective bargaining, employees must choose a union that will represent them, which is usually done through an election. Major areas in which a union may bargain are wages, hours, and working conditions of its members. When a branch or part of a professional association assumes the role and responsibility of a union, the negotiating group may be known as a collective action division (although it is legally considered a union). A professional organization works under the same legal constraints as any other union. Collective Bargaining Collective bargaining consists of a set of procedures by which employee representatives (typically a union) and employer representatives negotiate to obtain a signed agreement (contract) that spells out wages, hours, and conditions of employment that are acceptable to both. A key word is negotiating with the goal of negotiation to obtain a signed agreement, which is a legal contract that spells out in writing the decisions that are reached.