Abbreviation	Meaning
APS	Adult Protective Services
ARRA	American Recovery and Reinvestment Act (of 2009)
CE	covered entity
CPR	cardiopulmonary resuscitation
CPS	Child Protective Services
EPHI	electronic protected health information
HIPAA	Health Insurance Portability and Accountability Act
HITECH	Health Information Technology for Economic and Clinical Health Act
IIHI	individually identifiable health information
NINP	no information, no publication
PHI	protected health information
SNAT	suspected nonaccidental trauma

EXERCISE 1

Write the abbreviation for each term listed.

1. Adult Protective Services

2. American Recovery and Reinvestment Act

3. Child Protective Services

4. no information, no publication

5. suspected nonaccidental trauma

6. Health Insurance Portability and Accountability Act

7. Health Information Technology for Economic and Clinical Health Act

8. protected health information

9. covered entity

10. cardiopulmonary resuscitation

11. electronic protected health information

12. individually identifiable health information

EXERCISE 2

Write the meaning of each abbreviation listed.

Workplace Behavior

Workplace behavior may be described as a pattern of actions and interactions of an individual that directly or indirectly affects their effectiveness while at work. It reflects the attitude and amount of enthusiasm that the employee brings to the job. Today’s health care employees must perform their jobs efficiently and effectively while showing patients respect, patience, and empathy. We have all made decisions to buy or not buy a product or service based on the salesperson’s attitude or behavior. Patient survey responses that assess satisfaction with care are greatly influenced by the caregivers’ and other hospital employees’ attitudes or “workplace behavior.” Patient satisfaction may impact the patient’s choice of hospital for their health care or whether they submit a complaint. A variety of factors can influence a person’s workplace behavior.

Factors that Influence Workplace Behavior

1. Philosophy and standards of the organization

2. Leadership style of supervisors

3. Meaningfulness or importance of the work

4. How challenging the work is

5. Relationships with co-workers

6. Personal characteristics such as abilities, interests, aptitudes, values, and expectations

7. External factors such as family life, health, and recreational habits

Job satisfaction has a direct correlation to workplace behavior. It is important to choose a career and a position that will best meet one’s personal needs and aspirations. Many job options exist for a health unit coordinator (HUC) in the health care field. If one loves to be around children, pediatrics may be ideal, or if an individual wants to be challenged, the emergency room or an intensive care unit may be the best choice. If a job that will provide solitude is wanted, the recovery room may be an option, or if a more social setting is preferred, a medical-surgical unit may be a better choice. Consider options carefully.

Personal Values

Personal values reflect the beliefs or culture of an individual; that evolve from circumstances with the external world and can change over time. According to Morris Massey, a sociologist and producer of training videos, values are formed during three significant periods:

1. Imprint period from birth to 7 years of age—Like sponges, children absorb everything around them, especially from their parents, and accept much of it as true.

2. Modeling period from 8 to 14 years—Youths copy people, often their parents, but also other people such as teachers and religious leaders, and no longer have blind acceptance.

3. Socialization period from 15 to 21 years—Young adults are very largely influenced by their peers and by media that seem to resonate with the values of their peer groups. As young adults develop as individuals and look for ways to get away from their earlier programming, it is natural to turn to people who seem more like them.

Significant emotional events in our lives and other life experiences may change our values. For example, losing a loved one may cause one to treasure family and to value life in a way one had not before. Life experiences can change what we view as most important and can also help us gain empathy for others. Our values can have a major impact on how we relate to others and on the choices and decisions that we make. Diann B. Uustal, EdD, a well-known nurse and ethicist, describes values as being “a basis for what a person thinks about, chooses, feels, and acts on” (Uustal: Orthoped Nurs 11(3):11-15, 1992). The HUC position requires communication that is provided in a nonjudgmental way. Personal values may cause problems in certain interactions. Examining one’s value system is important in preparing to work in the health care setting.

SCENARIO

Joan, a HUC, has a father who was an abusive alcoholic. Joan is adamant about her feelings regarding alcoholics and is very much against drinking. Mr. Thomas is admitted because he was in a car accident that was caused by his drunkenness. Whenever Mr. Thomas approaches the desk to talk to Joan, she is very rude to him. Joan is allowing her personal values to influence her behavior. It is important to remain nonjudgmental when dealing with patients and their families and to not allow personal values to affect communication with others. At times this may be difficult, especially when one is communicating with a person who has been identified as an abuser of a child, a spouse, or an elderly person.

Influence of Personal Values in the Health Care Setting

A patient’s values can also influence a health care professional’s behavior when those values conflict with the health professional’s values.

SCENARIO

A patient is admitted with internal bleeding; his religion prohibits him from receiving a blood transfusion. Janet, a HUC, states aloud that she cannot understand how anyone could risk his or her life because of a silly religious belief.

The patient has a right to his own values and the right to refuse treatment.

Conversation and statements made at the nursing station or anywhere in the hospital may be overheard. Health care professionals must be aware of what they say and judgments that they make.

SCENARIO

Susan, a HUC working in the pediatric intensive care unit, says to John, a registered nurse (RN) who is taking care of a 5-year-old girl on life support after a near drowning, “Why don’t her parents take her off life support? Who’d want to live like a vegetable?” The little girl’s father overhears the comment, approaches Susan, and says, “Young lady, I hope you never have to make that decision.” Susan is devastated.

Values Clarification

Values clarification is an important tool for HUCs to use in preparing to become competent professionals. Either consciously or unconsciously, values guide personal and professional thinking. It is essential for HUCs to understand and be aware of their values and to remain nonjudgmental of the values others hold that differ from their own. Value conflicts include cultural, spiritual, social, and ethnic differences. There are times when it is difficult to remain nonjudgmental, especially when a child or elderly patient is admitted because of abuse and it is necessary to communicate with the probable abuser. One is entitled to one’s feelings, but it is important to remain professional and allow the doctors, nurses, and protective services personnel to do their jobs.

EXERCISE 3

This exercise is intended to guide you in examining your feelings and values related to future employment in health care. Complete the following sentences:

1. A patient has the right to

2. The health care team works best when

3. I fail to show respect for others’ values when

4. The most difficult situation to deal with would be

5. When communicating with patients and families, it is important to

Work Ethic

One’s work ethic refers to a person’s moral values regarding work. It is essential that the HUC demonstrate the work ethic traits discussed in the following sections.

Behavioral Traits that Make Up a Person’s Work Ethic

Behavioral Traits for “You” as a Health Unit Coordinator

Dependability: Patients and members of the health care team rely on you to report to work when scheduled and to be on time. You are also depended on to perform duties and tasks as assigned and to keep obligations and promises. Adequate sleep and abstinence from drugs are essential to maintain your dependability. Lack of sleep, use of illegal drugs, or misuse of prescription drugs would clearly endanger patients.

Accountability: Part of being dependable is being accountable. Accountability is taking responsibility for your own actions (i.e., being answerable to someone for something you have done). HUCs must be aware of and never exceed their scope of practice. If you are unable to report to work or to do your job, it is your responsibility to communicate this to the staffing office at least 2 hours before the scheduled shift.

Consideration: Be considerate of the physical condition and emotional state of the patients and your co-workers.

Cheerfulness: Greet and converse with patients and others in a pleasant manner. HUCs cannot bring personal problems to work. Sarcasm, moodiness, and bad tempers are inappropriate in the workplace.

Empathy: Make every attempt to see things from the viewpoint of patients, families, and co-workers. Keep in mind that stress and worry can affect people’s behavior, so refrain from treating a display of anger or frustration as a personal attack.

Trustworthiness: Your employer, patients, and co-workers have placed their confidence in you to keep patient information confidential. HUCs have access to a lot of information and must not engage in gossip regarding patients, co-workers, physicians, or the hospital.

Respectfulness: Respect is a primary value in health care and can be shown in many ways, including tone of voice, body language, attitude toward others, and attitude about work. All life is worthy of respect. We all have a right to our own value system and must respect that others have a right to theirs. Make every attempt to understand the values and beliefs of the patients and your co-workers that may differ from your own.

Courtesy: Be polite and courteous to patients, families, visitors, co-workers, and supervisors. Address people by name (e.g., Mrs. Johnson, Dr. Smith). Other courteous acts include saying “please” and “thank you” and not interrupting when others are speaking.

Tactfulness: Be sensitive to the problems and needs of others. Be aware of what you say and how you say it.

Conscientiousness: Be careful, alert, and accurate in following orders and instructions. Never attempt to perform a procedure or a task that you have not been trained or licensed to perform.

Honesty: Be sincere, truthful, and genuine, and show a true interest in your relationships with patients, families, visitors, and co-workers. If you make an error, bring it to the attention of the appropriate person(s). Never attempt to cover up an error!

Cooperation: Be willing to work with others, especially in the team-oriented climate of health care. When co-workers work as a team, everyone involved benefits.

Attitude: Attitude is a manner of thought or feeling that can be seen by others when they are observing your behavior. The tone of your voice and your body language can change the message you are trying to send. Your attitude will be reflected in your work. Be positive about your job and the contribution that you are making.

Overview of the Health Insurance Portability and Accountability Act

HIPAA is an acronym for the Health Insurance Portability and Accountability Act of 1996. Health providers and health plans are legally required to follow this act.

The act is composed of five sections. Components of HIPAA and changes to the original HIPAA legislation have gone into effect several times since 1996, including in 2003, 2005, 2006, and 2007. Additional changes to HIPAA included in the American Recovery and Reinvestment Act (ARRA) of 2009 significantly expand HIPAA’s privacy and security regulations.

Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. It establishes rules on how a group plan handles a preexisting condition.

Title II includes the Privacy Rule and the Security Rule—both enacted in 2003. The Privacy Rule establishes regulations for the use and disclosure of protected health information (PHI). The rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records and to request corrections (Box 6-1, Patient Rights as Outlined in the Health Insurance Portability and Accountability Act). The Security Rule applies to electronic protected health information (EPHI) or individually identifiable health information (IIHI) in electronic form. IIHI relates to (1) an individual’s past, present, or future physical or mental health or condition, (2) an individual’s provision of health care, and (3) past, present, or future payments provided for provision of health care to an individual; IIHI is information that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual.

BOX 6-1 PATIENT RIGHTS AS OUTLINED IN THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT