CMSA Today - Issue 7, 2016 - 23

Ethical Issues Professional Case Management's Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care BY ELLEN FINK-SAMNICK MSW, ACSW, LCSW, CCM, CRP INTRODUCTION Most professional case managers know that nagging feeling. Something happens on the job; it feels very wrong, to the point of untenable. The clinical gut each practitioner possesses and is warned to heed screams loudly for action to be taken, but exactly what action becomes the larger issue to reconcile. One known fact exists amid the rush of emotion and concerns prompting endless mental calisthenics. Independent of the course of action taken, these situations will impact the quality of care that every case manager advocates diligently to safeguard, with potential ethical, if not also legal consequences. Amid the fluid landscape of professional case management are five constants. These are the ethical tenets of practice: * Autonomy: To respect individual's right to make their own decisions * Beneficence: To do good * Fidelity: To follow through and keep promises * Justice: To treat others fairly * Nonmaleficence: To do no harm (Case Management Society of America, 2016) Each tenet, and subsequently each case manager, is challenged daily by rapidly shifting societal constructs (Fink-Samnick, 2013). Moving through 2016 into 2017, these issues present as tougher and more complex to manage, each one striking case managers at their ethical core. The Ethical Quartet for 2017 is composed of the following constructs: 1. Workplace bullying 2. End-of-life care 3. Technology and social media 4. Mandated duty to warn This article will span two parts, each providing a comprehensive overview of two constructs with respect to the scope, incidence, and considerations for professional case management practice. Part 1 will address workplace bullying and end-of-life care, with Part 2 to focus on technology and social media, as well as mandated duty to warn. In addition, there will be alignment with CMSA's recently revised Standards of Practice for Case Management (2016). Workplace Bullying DATA AND DEMOGRAPHICS Workplace bullying refers to the repeated, health-harming mistreatment of one or more persons (the targets) by one or more perpetrators. It is marked by abusive conduct that is: * threatening, humiliating, or intimidating, or * work interference - sabotage -which prevents work from getting done, or * verbal abuse. (Workplace Bullying Institute, 2016 ) The number of U.S. workers affected by bullying in the workplace has risen to well over 65 million persons, equivalent to the combined population of 15 states (Namie, 2014). This detrimental behavior is not limited to nurses who "eat their young" or physicians who berate and/or harass residents, plus other health professionals. Workplace bullying (also referred to as lateral violence) impacts the entire interprofessional team. It is four times more prevalent than sexual harassment or racial discrimination, with the healthcare profession having among the highest incidence (Drexler, 2013). Over 72 percent of employers deny, discount, encourage, rationalize, if not also defend this obstructive behavior (Farougque and Burgio, 2013; Namie, 2014). Bullying has a profound impact for professional case managers, particularly those who interface with interprofessional teams. This topic has been discussed with increasing frequency in the literature and has been related to gender predisposition, professional education and practice culture (both among and across distinct disciplines), as well as endemic to the healthcare culture overall (Dellasega, 2009; Fink-Samnick, 2015 and 2016a; Getz, 2013; Nesbitt, 2012; and Tulshayan, 2012). Another dimension to this dilemma aligns workplace bullying with medical errors, and the consequences of poor and/or fragmented team communications secondary to bullying and other disruptive behaviors (Fink-Samnick, 2016a; The Joint Commission, 2008). The industry continues to reel from research earlier this year that identified medical errors as the third leading cause of death in the United States (Cha, 2016). Back in the 1990s, medical errors were identified as an epidemic leading to the deaths of 44,000 to 98,000 people in the United States and warranting immediate attention (Institute of Medicine, 1999). Researchers broke down medical error occurrences across the categories of diagnostic, treatment, preventive, and other (Leape, et al., 1993). While failure of Issue 7 * 2016 * DIGITAL CMSA TODAY 23

Table of Contents for the Digital Edition of CMSA Today - Issue 7, 2016

PRESIDENT’S LETTER
ASSOCIATION NEWS
CMSA CORPORATE PARTNERS
Are You Culturally Competent?
Return to Culture – Return to Healing
Appalachian Culture: A Guide for Case Managers
Professional Case Management’s Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care
Diversity of Role Reversal: When the Case Manager Becomes the Patient
INDEX OF ADVERTISERS
CMSA Today - Issue 7, 2016 - cover1
CMSA Today - Issue 7, 2016 - cover2
CMSA Today - Issue 7, 2016 - 3
CMSA Today - Issue 7, 2016 - 4
CMSA Today - Issue 7, 2016 - 5
CMSA Today - Issue 7, 2016 - PRESIDENT’S LETTER
CMSA Today - Issue 7, 2016 - 7
CMSA Today - Issue 7, 2016 - 8
CMSA Today - Issue 7, 2016 - 9
CMSA Today - Issue 7, 2016 - ASSOCIATION NEWS
CMSA Today - Issue 7, 2016 - 11
CMSA Today - Issue 7, 2016 - CMSA CORPORATE PARTNERS
CMSA Today - Issue 7, 2016 - 13
CMSA Today - Issue 7, 2016 - Are You Culturally Competent?
CMSA Today - Issue 7, 2016 - 15
CMSA Today - Issue 7, 2016 - Return to Culture – Return to Healing
CMSA Today - Issue 7, 2016 - 17
CMSA Today - Issue 7, 2016 - 18
CMSA Today - Issue 7, 2016 - 19
CMSA Today - Issue 7, 2016 - Appalachian Culture: A Guide for Case Managers
CMSA Today - Issue 7, 2016 - 21
CMSA Today - Issue 7, 2016 - 22
CMSA Today - Issue 7, 2016 - Professional Case Management’s Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care
CMSA Today - Issue 7, 2016 - 24
CMSA Today - Issue 7, 2016 - 25
CMSA Today - Issue 7, 2016 - 26
CMSA Today - Issue 7, 2016 - 27
CMSA Today - Issue 7, 2016 - Diversity of Role Reversal: When the Case Manager Becomes the Patient
CMSA Today - Issue 7, 2016 - 29
CMSA Today - Issue 7, 2016 - 30
CMSA Today - Issue 7, 2016 - 31
CMSA Today - Issue 7, 2016 - 32
CMSA Today - Issue 7, 2016 - 33
CMSA Today - Issue 7, 2016 - INDEX OF ADVERTISERS
CMSA Today - Issue 7, 2016 - cover3
CMSA Today - Issue 7, 2016 - cover4
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http://www.nxtbook.com/nxtbooks/naylor/CMSQ1111
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