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THE NURSE AS INEMPLOYEE
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The Concept of a Professional Employer and Employee
Relationship
The Test for Determining the Existence of an Employer-
Employee Relationship
Rights and Responsibilities of a Nurse
Rights of Nurse-Practioners vis-a-vis Rights of Clients/Patients
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The Constitution of the Philippines provides that the
State shall afford full protection to labor, local and
overseas, organized and unorganized, and promote fullemployment and equality of employment
opportunities for all.
It shall guarantee the rights of all workers to self-
organization, collective bargaining and negotiations,
and peaceful concerted activities, including the right to
strike in accordance with law.
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They shall be entitled to security of tenure, humane
conditions of work, and a living wage. They shall also
participate in policy and decision-making processes
affecting their rights and benefits as may be provided by
law.
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There must be an employer-employee relationship in order
for the provisions of the Labor Code on the Labor Standards
to apply.
It follows that an individual who renders service outside of
the ambit of an employer-employee relationship is not
within the coverage of the statutory benefits or laborstandards of the Philippine Labor Code; hence, commercial
transactions (such as partnership, independent contracts,
co-ownership, self-employment, etc.) are beyond the scope
of the Labor Code.
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EMPLOYER
A legal entity that controls and directs a servant
or worker under an express or implied contract of
employment and pays(or is obligated to pay) him or
her salary or wages in compensation.
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EMPLOYEE
A person who is hired to provide services to
a company on a regular basis in exchange for
compensation and who does not provide these services
as part of an independent business.
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When an employer hires a new employee, he is not just
bringing a new member of the workforce aboard, he is also
starting a new relationship. Because employers and
employees often work in close quarters, they necessarilydevelop relationships.
Managing these relationships is vital to business success, as
strong relationships can lead to greater employee happinessand even increased productivity. To reap these benefits, keep
the dynamics of your employer-employee relationship in
mind.
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Relationship Basics
Generally, employer and employee relationships should be
mutually respectful. The degree of closeness in theserelationships will depend on both the employer and the
employee.
Some employers opt to keep their employees at a distanceand, in doing so, ensure that there is no confusion as to the
hierarchy that exists between them.
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Others elect to become friendlier with their employees,seeing this as a way to amp up employee happiness.
While neither option is entirely right or wrong, it is wise
to avoid getting too close to employees, as doing so can
cause the line between employer and employee to
become blurred
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Mutual Reliance
The employer-employee relationship should be one
of mutual reliance. The employer is relying upon the
employee to perform her job and, in doing so, keep
the business running smoothly.
Conversely, the employee is relying upon theemployer to pay her and enable her to support
herself, and potentially her family, financially.
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Relationship Building
Just as with all relationships, the employer and employeerelationship is one that must develop over time.
Employers can promote the building of relationships by
speaking candidly with their employees about their lives,
asking them about their families and learning about theirinterests.
Similarly, employees can promote the building of this
relationship by being open with their employer andsharing information about themselves and their lives.
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Boundaries
Though the type of employee and employer relationship that
is considered appropriate varies from company to company,
boundaries exist at almost all companies.
Generally, it is unwise for employers to develop romantic
relationships with their employees. Similarly, employersshould exercise care to ensure that the relationship they
develop with one employee isn't notably closer than the
relationships they develop with others, as this can lead to
concerns regarding favoritism or similar issues of unfairnesswithin the workplace.
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When can we say that an individual is considered as
an employee?
How can he prove that he is working for a certain
employer?
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Tests to Determine the Existence of
an EmployerEmployee
Relationship
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FOUR FOLD TEST
This test determines the existence of an employer - employeerelationship
1. Whether the alleged employer has the power of
selection and engagement of the employee (Power to
Hire)
Engagement means a contract within the business and
affiliations; Which means if there is a problem within the
vicinity of the employee it will be engaged to the employer,the same if there is a problem with the employer, changes will
be engaged to the employees.
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2. Whether the employee is being paid wages (Power to
pay wages)
Changes with the salary made by the employer must be
distributed well to all the employees; All employees means
the employer cant disregard any employee within hiscompany.
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3. Whether he has the power to dismiss
(Power to Discipline)
The employer has to power to dismiss, punish or
reprimand any employee, only if the employer has full
accountability and knowledge of the misconduct or
unprofessionalism of the employee.
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4. Whether he has control of the employee with respect to
the means and methods by which work is to be
accomplished (Power of Control)
The employer has the power to control his or her employees
by any means and methods he wants to accomplish the
companies goal, even if the way he wants it is time
consuming, it is the employers right.
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Economic Reality Test
In Sevilla v. Court of Appeals, the Court observed the need to
consider the existing economic conditions prevailing between the
parties, in addition to the standard of right-of-control, to give a
clearer picture in determining the existence of an employer-
employee relationship based on an analysis of the totality of
economic circumstances of the worker.
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Under economic reality test, the benchmark in analyzing
whether employment relation exists between the parties is the
economic dependence of the worker on his employer. That is,whether the worker is dependent on the alleged employer for
his continued employment in the latters line of business.
Applying this test, if the putative employee is economically
dependent on putative employer for his continued employment
in the latters line of business, there is employer-employee
relationship between them. Otherwise, there is none.
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Two-tiered test (or Multi-factor test)
The economic reality test is not meant to replace the right of control
test. Rather, these two test are often use in conjunction with each
other to determine the existence of employment relation between
the parties. This is known as the two-tiered test, or multi-factor test.
This two-tiered test involves the following tests:
The putative employers power to control the employee with respect
to the means and methods by which the work is to be accomplished;
and The underlying economic realities of the activity or relationship.
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The determination of the existence of employer-
employee relation must be tilted in favor of the
employee since any doubt in the interpretation of
the provision of the Labor Code shall be construed in
favor of labor.
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The determination of the existence of an
employer-employee must follow, not only becauseof the statutory provision but by humanitarian
reason as the employee is almost or most of the
time at the disadvantage situation and the law
must protect the disadvantaged.
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Nurse
A person educated and trained to care for the sick or disabled.
A woman employed to take care of a child; a nursemaid.
A woman employed to suckle children other than her own; awet nurse.
One that serves as a nurturing or fostering influence or means:
The American Heritage Dictionary of the English Language, Fourth Edition copyright 2000 by Houghton
Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.
http://www.eref-trade.hmco.com/http://www.eref-trade.hmco.com/8/13/2019 Nurse as an Employee
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Nursing encompasses autonomous and collaborative care ofindividuals of all ages, families, groups and communities, sick
or well and in all settings. It includes the promotion of
health, the prevention of illness, and the care of ill, disabled
and dying people.
World Health Organization
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ROLES AND RESPONSIBILITIESOF A NURSE
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1. Caregiver/ Care provider
The traditional and most essential role functions as nurturer,
comforter, provider mothering actions of the nurse, it also
provides direct care and promotes comfort of client, provide
activities involves knowledge and sensitivity to what matters
and what is important to clients and shows concern for client
welfare and acceptance of the client as a person
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2. Teacher
Provides information and helps the client to learn or acquire
new knowledge and technical skills, the nurse also
encourages compliance with prescribed therapy, promotes
healthy lifestyle and interprets information to the client
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3. Counselor
Helps client to recognize and cope with stressful psychologic or
social problems; to develop an improve interpersonal
relationships and to promote personal growth
provides emotional, intellectual to and psychologic support.
It focuses on helping a client to develop new attitudes, feelingsand behaviors rather than promoting intellectual growth.
Encourages the client to look at alternative behaviors recognize
the choices and develop a sense of control.
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4. Client advocate
Involves concern for and actions in behalf of the client to bringabout a change.
Promotes what is best for the client, ensuring that the clients
needs are met and protecting the clients right.
Provides explanation in clients language and support clients
decisions.
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5. Manager
Makes decisions, coordinates activities of others, allocateresources, evaluate care and personnel plans, give direction,
develop staff, monitors operations, give the rewards fairly and
represents both staff and administrations as needed .
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6. Researcher
Participates in identifying significant researchable problems,
in scientific investigation and must be a consumer of research
findings
Researcher must be aware of the research process, language
of research, a sensitive to issues related to protecting therights of human subjects.
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7. Change agent
Initiate changes or assist clients to make modifications inthemselves or in the system of care.
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8. Clinical Specialists
Is a nurse who has completed a masters degree in specialty andhas considerable clinical expertise in that specialty.
She provides expert care to individuals, participates in educating
health care professionals and ancillary, acts as a clinicalconsultant and participates in research.
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9. Nurse Practitioner
Is a nurse who has completed either as certificate program or amasters degree in a specialty and is also certified by the
appropriate specialty organization.
She is skilled at making nursing assessments, performing P. E.,
counseling, teaching and treating minor and self- limiting
illness
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10. Nurse-midwife
A nurse who has completed a program in midwifery;provides prenatal and postnatal care and delivers babies to
woman with uncomplicated pregnancies.
11. Nurse Educator
A nurse usually with advanced degree, who beaches in
clinical or educational settings, teaches theoretical
knowledge, clinical skills and conduct research.
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12. Nurse Entrepreneur
A nurse who has an advanced degree, and manages
health-related business.
13. Nurse administrator
A nurse who functions at various levels of management
in health settings; responsible for the management and
administration of resources and personnel involved in
giving patient care.
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NURSES RIGHTSVenzon, Lydia M. RN, MAN, PhD, FPCHA; Venzon, Ronald M., RN, MAN Professional
Nursing in the Philippines(2010) 11 The edition chapter 8 page 108
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1. Nurses have the right to practice in a manner that fulfills
their obligations to society and to those who receive
nursing care.
2. Nurses have the right to practice in environment that allow
them to act in accordance with professional standards and
legally authorized scopes of practice.
3. Nurses have the right to a work environment that supports
and facilitates ethical practice, in accordance with theCode of Ethics for Nurses and its interpretive statements.
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4. Nurses have the right to freely and openly advocate for
themselves and their patients, without fear or retribution.
5. Nurses have the right to fair compensation for their work
consistent with their knowledge, experience, and professional
responsibilities.
6. Nurses have the right to a work environment that is sale for
themselves and their patients.
7. Nurse have the right to negotiate the conditions of their
employment, either as individuals or collectively, in all practice
settings
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Rights of Patients
Philippine Patients Bill of Rights
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1. Right to Appropriate Medical Care and Humane Treatment.
Every person has a right to health and medical care correspondingto his state of health, without any discrimination and within the
limits of the resources, manpower and competence available for
health and medical care at the relevant time.
The patient has the right to appropriate health and medical care
of good quality.
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In the course of such care, his human dignity, convictions,
integrity, individual needs and culture shall be respected.
If any person cannot immediately be given treatment that is
medically necessary he shall, depending on his state of health,
either be directed to wait for care, or be referred or sent for
treatment elsewhere, where the appropriate care can
be provided.
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If the patient has to wait for care, he shall be informed of the
reason for the delay.
Patients in emergency shall be extended immediate medical care
and treatment without any deposit, pledge, mortgage or any form
of advance payment for treatment
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2. Right to Informed Consent.
The patient has a right to a clear, truthful and substantial
explanation, in a manner and language understandable to the
patient, of all proposed procedures, whether diagnostic, preventive,
curative, rehabilitative or therapeutic, wherein the person who will
perform the said procedure shall provide his name and credentials to
the patient, possibilities of any risk of mortality or serious sideeffects, problems related to recuperation, and probability of success
and reasonable risks involved:
:
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The patient will not be subjected to any procedure without
his written informed consent, except in the following cases
A. Emergency cases where death is a big risk in thesituation.
B. When controlling an epidemic that may pose risk to
community.
C. When a law make is compulsory for everyone
D. When a patient is a minor or legally incompetent; third
party is required
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E. When disclosure of material information to patient will
jeopardize the success of treatment, in which case, third
party disclosure and consent shall be in order.
F. When the patient waives his right in writing.
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Informed consent shall be obtained from a patient concerned
if he is of legal age and of sound mind. In case the patient is
Incapable of giving consent and a third party consent is required,the following persons, in the order of priority stated here under,
may give consent:
1. Spouse
2. Son or daughter of legal age
3. Either parent
4. Brother or sister of legal age
5. Guardian
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3. Right To Privacy and Confidentiality.
The privacy of the patients must be assured at all stages of his
treatment. The patient has the right to be free fromunwarranted public exposure, except in the following cases:
1. When his mental or physical condition is in controversy and
the appropriate court, in its discretion, orders him to submit
to a physical or mental examination by a physician.
2. When the public health and safety so demand
3. When the patient waives this right
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The patient has the right to demand that all information,
communication and records pertaining to his care be treated
as confidential.
Any health care provider or practitioner involved in the
treatment of a patient and all those who have legitimate
access to the patient's record is not authorized to divulge anyinformation to a third party who has no concern with the care
and welfare of the patient without his consent, except:
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Informing the spouse or the family to the first degree of the
patients medical condition may be allowed; Provided, That the
patient of legal age shall have the right to choose on whom to
inform.
In case the patient is not of legal age or is mentally incapacitated,
such information shall be given to the parents, legal guardian or
his next of kin.
4 Ri h I f i
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4. Right to Information.
In the course of his/her treatment and hospital care, the patient or
his/her legal guardian has a right to be informed of the result of theevaluation of the nature and extent of his/her disease, any other
additional or further contemplated medical treatment on surgical
procedure or procedures, including any other additional medicines
to be administered and their generic counterpart including
the possible complications and other pertinent facts, statistics or
studies, regarding his/her illness, any change in the plan of care
before the change is made, the persons participation in the plan of
care and necessary changes before its implementation, the extent
to which payment maybe expected from Philhealth or any pay orand any charges for which the patient maybe liable, the disciplines
of health care practitioners who will furnish the care and the
frequency of services that are proposed to be furnished
5 The Right To Choose Health Care Provider and Facility
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5. The Right To Choose Health Care Provider and Facility.
The patient is free to choose the health care provider to
serve him as well as the facility except when he is under the
care of a service facility or when public health and safety so
demands or when the patient expressly or impliedly waives
this right.
The patient has the right to discuss his condition with aconsultant specialist, at the patients request and expense.
He also has the right to seek for a second opinion and
subsequent opinions, if appropriate, from another healthcare provider/practitioner.
6 Ri ht t S lf D t i ti
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6. Right to Self-Determination.
The patient has the right to avail himself/herself of any
recommended diagnostic and treatment procedures.
Any person of legal age and of sound mind may make an advance
written directive for physicians to administer terminal care when
he/she suffers from the terminal phase of a terminal illness:
Provided, That
a)He is informed of the medical consequences of his choice;
b)He releases those involved in his care from any obligation relativeto the
consequences of his decision;
c)His decision will not prejudice public health and safety.
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7. Right to Religious Belief.
The patient has the right to refuse medical treatment
or procedures which may be contrary to his religious beliefs,subject to the limitations described in the preceding
subsection: Provided,
That such a right shall not be imposed by parents upon theirchildren who have not reached the legal age in a life
threatening situation as determined by the attending
physician or the medical director of the facility
8 Ri ht t M di l R d
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8. Right to Medical Records.
The patient is entitled to a summary of his medical history and
condition, He has the right to view the contents of his medicalrecords, except psychiatric notes and
other incriminatory information obtained a bout third parties,
with the attending physician explaining contents thereof.
At his expense and upon discharge of the patient, he may
obtain from the health care institution a reproduction of the
same record whether or not he has fully settled his financial
obligation with the physician or institution concerned.
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The health care institution shall issue a medical certificate to the
patient upon request.
Any other document that the patient may require for insurance
claims shall also be made available to him within a reasonable
period of time.
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9. Right to Leave
The patient has the right to leave a hospital or any other health
care institution regardless of his physical condition: Provided,That
a) he/she is informed of the medical consequences of his/her
decision;
b) he/she releases those involved in his/her care from any
obligation relative to
the consequences of his decision;
c) his/her decision will not prejudice public health and safety.
No patient shall be detained against his/her will in any healthcare institution on the sole basis of his failure to fully settle is
financial obligations.
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10. Right to Refuse Participation in Medical Research.
The patient has the right to be advised if the health care
provider plansto involve him in medical research, including but not
limited to human experimentation which may
be performed only with the written informed consent
of the patient.
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11. Right to Correspondence and to Receive Visitors
The patient has the right to communicate with relatives and
other persons and to receive visitors subject to reasonablelimits prescribed by the rules and regulations of the health
care institution
12 Ri h E G i
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12. Right to Express Grievances.
The patient has the right to express complaints and grievances
about the care and services received withoutfear of discrimination or reprisal and to know about the
disposition of such complaints.
The Secretary of Health, in consultation with health care
providers, consumer groups and other concerned agencies
shall establish a grievance system wherein patients may seek
redress of their grievances.
Such a system shall afford all parties concerned with theopportunity to settle amicably all grievances
13 Right to be Informed of His Rights and Obligations as a
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13. Right to be Informed of His Rights and Obligations as a
Patient.
Every person has the right to be informed of his rights andobligations as a patient. The Department of Health, in
coordination with health
care providers, professional and civic groups, the media, health
insurance corporations, peoples organizations, local government
organizations, shall launch and sustain a nationwide information
and education campaign to make
known to people their rights as patients, as declared in this Act.
Such rights & obligations of patients shall be posted in a bulletinboard conspicuously placed in a health care institution.
http://smallbusiness.chron.com/employeremployee-
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http://smallbusiness.chron.com/employeremployee
relationship-16737.html
Francisco vs. NLRC, G.R. No. 170087 August 31, 2006
Religious of the Virgin Mary vs. NLRC, G.R. No. 103606,
October 13, 1999
Viaa vs. Al-Lagadan and Piga, 99 Phil. 408 (1956).
Sevilla v. Court of Appeals, G.R. Nos. L-41182-3, April 15,1988.
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