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Worker's compensation is insurance coverage for employees to compensate them in case they are injured while performing their job. The employer pays a premium that covers medical expenses and lost wages in case their employees are injured. If these benefits are excepted the hurt employee must release the employer of further liability. The insurance company pays the claim and the employee can no longer sue the employer for the injury.
Jordane Bergnaum
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What is a GMS test for doctors?
The General Medical Council (GMC) test is a yearly compentancy exam that has been proposed in Britain to weed out incompetent doctors.
Effect of cultural diversity in giving care?
A difficult question for many reasons. In an ideal world, increasing cultural diversity amongst caregivers would offer the twin benefits of acquainting caregivers with the mores and modalities of other cultures, thus improving communications and increasing awareness patient care issues and of potential patient conditions endemic to specific areas or cultures (for instance, the cultural dietary can cause some sneaky problems with biochemical intolerance of certain foods) -- and it would allow those caregivers shared a cultural background with patients to greatly enhance communication when the patient is in extremis and communications are at their most difficult. More, as the patient's family becomes more and more a part of of the patient's support system, knowing how families of other cultures work would have to improve healthcare. However, in this less than ideal world, cutural diversity has had some difficulties in application. The root problem is language. In addition to native language, medicine has its own very specific, very formal jargon, some of it in Latin in some cultures an in other languages in others. Add to this that in the healthcare environment, there always develops a patios or vernacular. Very often all three of these -- normal day-to-day language, formal medical dialogue and the patios happen at the same time and, in the event of an emergency, they all three are spoken very fast. It's a lot to ask for someone to pick all this up without living in the environment for a few years, which is often not the case. An example: Some years ago in Southern California, a large number of RN's emmigrated from Seoul. These nurses may have been well trained, but many of them spoke no English on arrival. The State Boards decreed that any of these RN's who failed to pass their boards were allowed to retain their RN registration and to continue nursing for a period of two years, at which time they'd have to take the test again. So lots of Korean nurses with no English and with training in Seoul's methodology were dumped into the California system. In a perfect world, this might have had some wonderful effects, as Southern Calif has a large Korean population, and this could have really opened some doors. In reality, it didn't. Koreans who spoke no English tended to avoid other cultures (and there were a few -- Mexicans, Americans, Philipinos) who spoke no Korean. Verbal communications with patients who spoke no Korean came to a complete standstill. And as Seoul didn't always follow the same medical and pharmacological procedures, and no means of acculturation had yet appeared on the horizon, you could see trouble was forming. And a trauma center may be one of the worst places in the world to learn widely divergent linguistics. One example: Heparin is a powerful anticoagulant. It's provided in different concentrations, all labeled -- in English -- and some with special warning labels. A patient was admitted with a suspected thrombosis -- something you'd use Heparin for, and I think the order given was to inject Heparin directly IV into the port on the IV line -- not into the bag of Normal Saline. When you mix Heparin into a liter of solution, you can use a very concetrated form of Heparin, but when you directly IV it, the concentration (which means the dosage in this case) has to be MUCH lower. The Korean nurse who responded picked up the wrong ampoule, couldn't read the concentration, didn't know about the warning label, and was about to IV a dose of hugely concentrated Heparin into the patient when one of the other nurses caught her in time to save the patient's life. I want to emphasize that this doesn't reflect on the Korean nurse's compentancy in the least. It was clearly an innocent and, under the circumstances, probably unavoidable mistake. But -- as I mentioned before -- the lack of a common language and the lack of a lengthy time to acclimate turned what could have been a golden opportunity into a series of disasters and close calls. The end of this program saw almost all the Korean nurses dropping out --- a loss for everyone. So I suppose the bottom line is that effective integration of cultural diversity takes time -- at least enough to learn the language. Without communication, acculturation meets an insurmountable barrier.
