Sample Essays on Ethical Code of Conduct for a Long-Term Care Facility

Ethical Code of Conduct for a Long-Term Care Facility

1.0 Introduction

The ethical code of conduct for long-term-care facility refers to procedures and guidelines that will govern the personal conduct of all employees working in the facility. Long-term care facilities develop and implement ethical code of conduct here after referred to as the code, as a way of ensuring that they achieve the highest level of care using ethical and integrity standards. It is the duty of employees across all levels of the organization to ensure that they follow all the ethical codes, particularly, those included in the facility`s code of ethics. According to Darr (2002), patients look for care in different healthcare facilities and long-term care facility is one of them. Each healthcare organization operates differently and as a result, each has a different code of conduct. A long-term care facility operates differently from a surgery center or a specialty hospital (Joint Commission, 2008). The majority of healthcare organizations have a code of conduct that all their employees are expected to follow. The code provides a set of behavior standards for all people within the facility. The code includes particular standards of behavior that governs the relationship between the employers and their employees, and stipulates how they interact professionally with their customers and the general public (Bardetti & Moriarty 2009). A professional code of ethics is important for a long-term care facility and its employees because of their access to protected and confidential financial and medical information that the facility`s employees are privy to. Consequently, all long-term care facility workers are required to abide by the code fully, which brings integrity in the field of healthcare delivery. This paper will focus on the on a long-term care facility. The code will cover employees at all levels of the organization including but not limited to professionals, support staff, and those in managerial roles.

2.0 Background of the Facility

            A long-term-care facility refers to a healthcare organization that offers both medical and non-medical services to patients with chronic illnesses or with disability. Similarly, some long-term-care facilities take care of aged patients who by the virtue of their age no longer have the ability to look after themselves. As a result, such populations require around the clock expert care from professionals (U.S. Department of Health and Human Services, 2014). Compared to other specialties, a long-term-care facility offers more to its patients and clients. For example, in a long-term care facility, employees assist patients in their day-to-day life tasks such as bathing, dressing, and in some cases feeding (Boulding, 2000). In addition, long-term care may also include provision of medical care requiring professional skills to address issues related to persistent diseases that come with old age. In the United States, a significant number of long-term care facilities are located in formal places that provide services such as living quarters for patients in need of around-the-clock medical care and other types of care like personal care and meals. In some instances, long-term care can be offered in a patient`s home. In this paper, we discuss long-term care in the context of a nursing home-a formal long-term care facility. For many countries across the globe, there has been a significant increase in life expectancy in the past few decades, and with the increase in elderly population, chronic diseases have increased too. In some cases, the old lack the capacity to look after themselves and have to depend fully on others` care. According to the World Health Organization (2014), with the rapid increase in elderly populations, there is an urgent need to for effective and customer-centered long-term care. World Health Organization (2014) estimates that approximately 12 million people over 65 years of age will require long-term care by 2020. In the U.S., four in every 10 people who will attain 65 years will require long-term care in the course of their lives.

3.0 Organization Structure

The structure of a long-term facility differs from that of other healthcare providers. To begin with, all long-term care facilities, particularly nursing homes are private entities. The organizations structure for this nursing home includes the owner, the medical director, and the administrator at the management level. At the operational level, we have the medical service department comprising of a physician assistant, nurse practitioner, attending physician, pharmacist, and a clinical nurse specialist. The nursing services department includes the director of nursing, assistant director of nursing, in charge nurses for all shifts, and division supervisors. Below the division supervisors are the Licensed Practical Nurses who perform a supervisory role over all the certified nurse assistants. In addition, the facility has other skilled healthcare workers including speech therapists, dentists, physical therapies, occupational therapist, and podiatrist (Pattison, 2001). Other important employees that form part of the organization`s structure include the business director, admissions director, and dietary supervisor.

4.0 Duties and Responsibilities of Management and Professional Staff

There are various duties and responsibilities for the different employees in a long-term health facility. We evaluate the duties and responsibilities for skilled and professional staff and those of upper management. The responsibilities and duties of upper management vary. Management is directly involved in planning, supervision, monitoring, and ensuring the highest standard of care are maintained across supervision, monitoring, and ensuring high quality of care is maintained across all the departments in the facility. Effective management of a long-term care facility requires good communication flow between management and staff. In addition, the management team must have business acumen and effective leadership. Those in managerial positions are responsible for the planning and directing of all activities in the facility using the framework set by the facility`s board of directors. These activities include effectively monitoring the operations of various groups that include medical, nursing, social services, technical, and clerical teams. On the other hand, the duties and responsibilities for skilled and professional staff include making sure that all the facility`s patients and clients are taken care of in a professional manner and that they receive their prescribed medication on time and as scheduled. The facility`s doctor has a responsibility of ensuring that all customers are examined on a regular basis.

5.0 Two Possible Ethical Dilemmas

An ethical dilemma refers to a situation involving an ethical or a moral conflict between doing something right or wrong. Ethical dilemmas are a common phenomenon in long-term care facilities and they may involve situations such as terminating an individual`s life, decision making on hospitalization, and use of sedation (Bardetti & Moriarty, 2009). In healthcare setting, ethical dilemmas normally require healthcare providers to arrive at decisions that may conflict with the ethical norm (Pozgar, 2011). Numerous ethical dilemmas may happen to both the management and professional staff in a long-term care facility.

The first example is when medical team in the facility are given special orders of Do-Not Resuscitate in a patients chart, yet they get conflicting views from the patient`s family. For example, a patient in urgent need of hospitalization has mild dementia and has difficulties in breathing. The facility`s personnel are convinced that hospitalizing the patients under short-term intubation can improve his chances of survival. However, the patient`s wish is that he should be given no life support if he has a terminal condition. The dilemma here is that this patient is lucid and has not reached the fatal state. The facility`s medical staff are in a dilemma on whether to go by the patient`s wishes or ignore the of Do-Not Resuscitate orders on the chart and hospitalize this patient with an intubation? Similarly, given that this patient and understands the conditions in which he is under, should the doctors ask him if he wishes to be hospitalized under intubation?

The second ethical dilemma that licensed practical nurses and registered nurses in a long-term care facility can face relates to applying restraints on patients suffering from dementia. A number of dementia patients are often hostile and combative and as a result, they require special attention as a way of ensuring their own safety. The most popular way to achieve this is through using restraints. However, this practice has come under heavy criticism on grounds that it may cause physical harm to patients and infringe on their independence, freedom, and respect. The employees at this facility have to make a fine distinction on situations that warrant restraint and how it should be applied without violating the autonomy and freedom of the patients. These are examples of dilemmas that both management and medical staff at the facility are likely to encounter. According to Numminen, Van der Arend, & Leino-Kilpi (2009), long-term health facilities are often understaffed unlike tertiary care centers that have sufficient clinical ethicists. However, even with fewer professionals at their disposal, the employees have to ensure that their actions are in the best interest of the patients and that they are consistent with the ethical guidelines set by the facility.

6.0 Ethical Standards for the Facility`s Staff

Every organization requires an ethical code of conduct that not only directs behavior between the field of healthcare and management, but also governs the relationship between various stakeholders including patients, employees and the society. The fundamental function of a code of ethics is to help those performing managerial and professional duties to sustain a system that enhances the quality of life and improves the wellbeing and dignity of all patients and clients in need of healthcare services (Gordon & Rosenberg, 2001). Those in management positions have to conduct themselves in a manner that instills respect, trust, and confidence to the healthcare profession. Prior to implementing an ethical code of conduct, the codes should contain the values of the organization, its culture and mission statement. The long-term care facility should choose the type of values that are vital to the organization`s long-term survival. The following ethical code of conduct will work well for the long-term care facility:

  • Undertake all medical and professional activities in good faith and with integrity, honesty, and respect.
  • Comply with all the regulations and laws relating to long-term care while promoting and sustaining transparency and proficiency.
  • Work toward the implementation of procedures and processes that will safeguard the privacy and confidentiality of all patients and clients.
  • Practice care that advances compassion, while delivering the best quality of care to both patients and their family members.
  • Ensure that all care services provided at the facility are consistent with existing regulations and care at all times.
  • Promote the education and training of all employees on the code of conduct and implement measures to deal with emerging concerns.
  • Treat all patients with dignity regardless of their racial and cultural backgrounds
  • Remain truthful in organizational and professional communication and report all negative financial information in a prompt manner to authorities to prevent deceptive or misleading information.
  • Give utmost respect to the wishes and rights of individuals in the facility even when they conflict with popular norms.
  • Report all cases of abuse or suspicions of abuse
  • Provide accurate and reliable information to potential customers to help them make informed decisions on long-term care.
  • Develop and promote a culture that does not discriminate based on ethnicity, race, age, religion, gender, disability, or sexual orientation.

The ethical code of conduct listed above is useful in the effective management of the long-term care facility. However, it is worth noting that the code of ethics and conduct will work only if the leadership fully supports the regulations and enforces them with rewards for compliance and sanctions in case they are violated. The facility`s management have a responsibility to the patients and their family members to act in a manner that inspire trust and confidence.

7.0 Methods of Implementing the Code to Achieve Compliance

            The majority of healthcare facilities and particularly long-term care facilities have ethical code of conduct for their organizations. However, the major problem is how to execute the code of conduct and ensure that all employees across all levels of the organization comply. The facility can use numerous ways to implement the code across the organization. The first step in implementing the code of conduct has already been developed-the development of the ethical code of conduct. The following subsequent procedures will ensure that the code of conducted is fully implemented across the organization and ensure that they are fully complied with. They include:

  • Hire compliance officers who will be provide guidance and synchronize the code`s implementation. The officer will be further responsible for establishing training and communication on all subject matters related to ethics and code of conduct.
  • The facility should put in place mechanisms to supervise and audit the process and put in place anonymous methods that employees can use to blow the whistle on non-compliance
  • The facility should undertake an in-house survey as a way of identifying which areas stakeholders believe might cause ethical dilemmas. The areas identified should then be discussed and employees at all levels should find ways of tackling the problems beforehand.
  • The code of conduct should not only be visible but also readily available to all employees. Management should ensure that they print, post and display code of conduct, with every department head given parts of the code appropriate to the department`s employees.
  • As a way of ensuring that all employees know what is important to the organization, all workers ought to be informed on the goals of the facility, their specific roles and responsibilities, and the expectations and priorities of their positions.
  • It is impossible to implement the code successfully if the facility does not live up to its corporate values. As a result, employees at all levels have to be empowered on decision making in a manner consistent with the corporate values. In addition, the facility should also be strict in compliance and pursue a zero tolerance policy toward those who fail to comply with the laws.

A code of conduct incorporates all behaviors that the long-term care facility will not tolerate and the consequences that will follow if they are not followed. The code will help the facility in keeping the organization and its employees safe from both real and imaginary unethical practices. It permits the employees to know which types of conduct are harmful to the facility and the likely consequences that will follow from those types of conduct.

8.0 Consequences in the Event of Violation

The majority of long-term care facilities have a zero tolerance policy toward employees who violate their code of conduct, particularly those relating to patient rights. Numerous disciplinary measures can be taken against any employee who contravenes the ethical code of conduct. The punishment used depends on the type and extent of the violation. Sanctions may include written warnings and in extreme cases, they may be fired. Long-term care facilities are expected to offer high quality of care to their clients. As part of quality, they are expected to provide service with the highest ethical, legal, and business standards (Noelker & Harel, 2001). These standards are applicable in the daily interactions with others in the facility including family members, patients and the public. For many businesses in the long-term care specialty, complying with the ethical code of conduct is a prerequisite for employment and any person found in breach of the ethical code of conduct has to face severe disciplinary action. In some cases, they are dismissed from employment. The facility should make use of numerous corrective measures to discipline those who disobey the codes. Corrective measures may include offering addition training to the offender, refund of copayments in the case of bills paid, and providing written warnings. Disciplinary measures against offending employees should be based on which code of conduct violated and the nature of the individual employee to prevent discrimination and unfair sanctions.

9.0 Conclusion

The ethical code of conduct for the long-term care facility offers a procedure and guideline for the organization`s employees on how they should conduct themselves. The code of conduct provides a set of behaviors to be followed by all in the facility. It governs the relationship between the employees, employer, and their professional interaction with the patients and the public. The facility`s structure as a long-term care facility is quite different from other healthcare organizations. The structure is comprised of the owner, the medical director, and the administrator. The facility has numerous duties and responsibilities for the different positions in the facility. Ethical dilemmas involve ethical and moral conflicts between doing the right thing and doing the wrong thing. The fundamental function of an ethical code of conduct is to help the management team and professional staff to sustain a system that enhances the quality of life, dignity, and wellbeing of all persons in need of care services.


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