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Work ethically (Audiometry)

Contents

Introduction 2 Follow ethical guidelines in decision-making 2 Roles and responsibilities of members of the team 7 Patient complaints 9 Reflect understanding and compliance with duty of care and legal responsibilities 10 Refer breach or non-adherence to standard procedures or adverse event to appropriate personnel 14 Maintain confidentiality of client matters 16 Show respect for rights and responsibilities of others 17 Reflect current working knowledge and understanding of employee and employer rights and responsibilities 19 Recognise, avoid and/or address any conflict of interest 24 Summary 25 Feedback to Activities 26

Resources: The following resource is available in Your resources. Resource 1: Provide security and storage for medical records Some useful websites: Australian College of Audiology (ACAud): www.acaud.org/ NSW Department of Community Services website: www.community.nsw.gov.au/ Audiological Society of Australia: www.audiology.asn.au/ Human Rights and Equal Opportunity Commission at: www.hreoc.gov.au NSW Anti Discrimination Board at: www.lawlink.nsw.gov.au/adb Workplace Authority (Australian government): www.workplace.gov.au/workplace/Publications/News/Theworkplacerelationssystem.htm#booklet Health Services Union of Australia: www.hsu.net.au/campaigns/yourrightsatwork/resources/1124853039_21377.html/

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WorkChoices (Australian federal government): www.workchoices.gov.au/ Workplace Authority (Australian federal government): www.workplaceauthority.gov.au Australian Council of Trade Unions (ACTU): www.actu.asn.au/AboutACTU/default.aspx

Introduction As an audiometrist, you might find yourself in situations where you’re not sure what to do—where you are not quite sure what’s right and what’s wrong. This topic shows you that there are laws covering what is right and what is wrong, as well as guidance from various professional bodies. Laws governing discrimination and privacy (people’s right to control what happens to their personal information) also impact on the hearing health industry, and we show you how to avoid breaking these laws.

Follow ethical guidelines in decision- making As someone working in the hearing health industry, you need to be aware of potential ethical complexity in your work role.

Ethical principles suggest that all members of the hearing health team have certain obligations and responsibilities to their clients and to each other. This means that we should be able to work together harmoniously and be willing to help each other whenever needed.

The principal of a clinic or hearing centre has the ultimate responsibility for the well-being of clients and the actions of employees. Having said that, there are situations within hearing health care clinics whereby each member of the team, including the audiometrist, will be considered directly liable for his or her own actions. If you are working in a small rural or remote centre, the director or owner of the centre would be the principal.

Code of ethics

A code of ethics is a set of moral principles and practice standards which a profession uses to guide practice.

Codes of ethics are usually voluntary controls and not laws that serve as a means of regulation within a profession.

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For the team, ethics means that all members have certain obligations, and responsibilities, to their clients. We should be able to work together in close harmony and be willing to help each other whenever needed.

Code of ethics—for audiometrists

How will the code of ethics affect audiometrists as they go about their work every day in the surgery, office or laboratory? This is an important and interesting question. Go to the website below to find out more.

Visit the Australian College of Audiology (ACAud) website, and read through the Code of Ethics:

www.acaud.org/

From the code of ethics on the website you will note that the welfare of the client is paramount—over your self-interest, or the interest of employers or colleagues.

Ethical dilemmas

Ethical dilemmas are recognisable by the fact that there are at least two sets of values involved, and you are being asked to decide which is most important. Being faced with conflicting values usually gives us a sense of confusion and makes us feel unsure. You need to ask yourself: what is the most important point here?

As a worker, your primary responsibility is to safeguard the client’s rights, but sometimes the best way to do this is not always clear. Other workers, carers or family members may see the situation differently. The situation may not be clear-cut.

Ethical dilemmas can be roughly categorised in the following ways: competing values; multiple client system; and value dilemma.

Competing values

What are conflicting values?

It is about being faced with a choice between two conflicting moral principles and it is not clear-cut which choice will be the right one.

Sue is an audiometrist who has been carrying out hearing screening tests on high school children. She smells alcohol on the breath of a few of the students being tested and she has good reason to suspect that they might also be taking illegal substances.

Sue wonders whether she should report the students to their school principal. She acknowledges the students’ right to self-determination (the

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case for not intervening) versus the value of protecting human life (the case for intervening). However, although Sue is a strong advocate of the individual’s rights, she cannot defend the right of the individual to inflict harm on themselves and others and to break the law.

Reflect on whether you have come across a situation that was not clear-cut, where there were conflicting values.

Multiple client system

Your client may have certain priorities and concerns, but there may be parents/carers in the person’s life who view the situation differently and have conflicting concerns. To whom does the worker owe the primary obligation? The answer should always be to the client first, but this is not always straightforward when the client may be heavily reliant on others to care for them. An example would be an ageing person who does not want a hearing aid while family members want the person to wear one.

Here’s another example: a client resident in a nursing home who tells you they will only use small in-the-ear hearing aids (ITE hearing aids) while the management strongly prefers large behind-the-ear instruments (BTE) that require less staff support for use.

Value dilemma

This is where your own personal values may conflict with the action you need to take. For example, you may be assessing a child’s hearing and notice a bruise on a child. The mother breaks down and cries, and tells you that if she is reported again she has been told her child will be put into foster care. You know the family is close-knit. You also know that they have been living with a lot of stress. You have the dilemma of wanting to cause the least harm to the family. On the one hand, you wonder if reporting the incident to the Department of Community Services (DoCS) is going to cause further stress to the family and, thus, escalate the situation.

Here is another example:

Maria is a community health nurse who lives next door to a family consisting of a mother and three children under the age of six. Maria notices that the children are always grubby and often sick. She thinks that they eat a lot of junk food. She sometimes thinks that the mother is neglectful.

Human experience is very complex, isn’t it? The question really is whether the children are at risk from harm.

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Remember that you know you must always consider your legal responsibility under the NSW Children and Young Persons (Care and Protection) Act 1998, to notify the department when you suspect child abuse or risk of harm.

Find out more about protecting children at the NSW Department of Community Services website:

www.community.nsw.gov.au/DOCS/STANDARD/PC_101108.htm

www.community.nsw.gov.au/DOCS/HOMEPAGE/pc=pc=HOME.HTML

Ethical dilemmas are recognisable by needing to ask the ‘But, what if …?’ question and the feeling of confusion or tension around how to respond.

Unethical conduct

Conduct is unethical when you can see that another person is not adhering to professional ethics and is behaving in a way that puts clients at risk.

Examples of unethical conduct could include situations when:  a fellow worker is overheard gossiping about a client or co-worker, either at work or in the community  a fellow worker is openly intolerant of other cultures (or religions) and says negative things about people belonging to those groups  workers joke about people who they see as ‘different’ from themselves (eg people who are gay, people with certain physical characteristics)  two workers argue with each other in front of clients  a supervisor tells you that in order to maximise company profits you must put pressure on Government-funded clients to ‘top-up’ by paying a contribution to get more expensive hearing aids.

A code of ethics helps us to identify unethical situations, and is therefore important to think about regularly. It should never be a dead piece of paper stuck at the back of the filing cabinet.

It is important to work to build an atmosphere of trust, respect and candour in the workplace by:  encouraging openness and tolerance between colleagues  accepting their right to hold different points of view  using constructive methods of conflict resolution  maintaining appropriate confidentiality.

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If we have a trusting atmosphere, hopefully we can confront potentially unethical behaviour and support each other to act professionally at all times.

Standards

There are also some standards that apply to all businesses, and some of these are outlined below.

Confidentiality

It is important to keep your clients’ business as just that–their business. You should only discuss matters relating to your clients’ business with co- workers, and then only what needs to be discussed. Discussions should take place in the workplace and not be audible to other members of staff or the general public. You should never discuss clients’ business with family or friends.

To learn more about security and storage of medical records, including exactly what types of information is confidential and your legal obligations, go to the resource below.

Go to Resource 1

This resource is available in Your resources.

Discretion and tact

It is important to be discreet about many matters in the workplace. Think before you make comments or express personal viewpoints and be tactful when responding to someone else’s critical or negative comments. Even if you agree with them, your comments will often be repeated to other people.

Punctuality

Punctuality is very important in the business world. While ‘time is money’ is a cliché, keeping people waiting implies that your time is more valuable than their time. If you are running late for an appointment you should always try to contact the client (or your supervisor) and you should always apologise.

Courtesy

Treat your clients and co-workers as you would like to be treated. Use polite language and consider their needs.

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Dependability

It is important that you develop a reputation as a dependable staff member. Being dependable means that you finish jobs you start, you follow through on jobs and you do what you say you are going to do.

Honesty

Honesty is not only to do with money. It also has to do with how you relate to other people. Honest people tell the truth, admit their mistakes and are willing to say what they do and don’t know. Honesty will earn you respect from both your clients and co-workers.

Loyalty

Loyalty to your organisation is important. You are often the first and main representative of your company to your client. You should never criticise other staff members or the organisation to your clients. If mistakes have been made, you should apologise in a way that represents the organisation positively and professionally.

Being loyal does not mean that you have to make exaggerated claims about how great your organisation and its services are. Avoid claims that put your organisation in a good light but that are misleading, inaccurate and untrue.

Roles and responsibilities of members of the team

Responsibilities in the workplace

Your responsibilities involve client care, loyalty to your employer, and being a team member.

The following points outline your ethical responsibilities in the workplace:  always give support to your supervisors and colleagues  accept direction and supervision by the audiologist  maintain the ethical standards of your manager in dealings with the public, clients and team members  perform only those duties delegated by your manager which you are able to do according to your experience and training  carefully follow instructions and work to the best of your ability  always behave in a professional manner

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 try to maintain a positive mental attitude  try not to bring your personal problems to work.

If, in your employment, you find that you are unable to accept any of the abovementioned points, then you probably need to re-consider what you want in a career.

Responsibilities to co-workers

As a member of a team you are expected to work effectively with fellow staff members.

The work-based relationships you form are founded on the same principles as any other relationship in your life: co-operation, mutual respect, trust and loyalty, reciprocal effort, such as the following:  treat your fellow workers with the respect that you would like them to give you  work in a spirit of teamwork  perform your duties carefully  do not palm your duties off to someone else  when you are not busy with your own duties, see if anyone else would like a  hand with his/her work, especially in the case of an emergency  be on time for work  do not take unnecessary days off, as this will put pressure on the other team members  when you want to take a holiday, give plenty of notice so that your employer can make arrangements for your position to be covered  accept criticism or change when it is given in a constructive manner  handle grievances by talking to the team member involved, or discuss the grievance at a staff meeting before it becomes a major problem  keep up-to-date with your field by continuing to attend education programs and seminars.

It is so important to have a pleasant personality, a sincere interest in your clients, a genuine interest in audiology and, above all, an acceptable work attitude.

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Obligations towards patients

An audiometrist shares the audiologist’s obligations and responsibilities towards their patients. These are outlined below.  Your primary responsibility is the health, welfare and safety of the patient. You should do all in your power to assist in this endeavour  Carry out only the treatment that is within your areas of competence. Where necessary, appropriate referral for advice or treatment to other professional colleagues should be arranged.  Accept full responsibility for all treatment you undertake. Audiologists also accept responsibility for the treatment undertaken by other staff acting, as permitted by the law, under their direction, supervision and control.  No service or treatment shall be delegated to a person who is not qualified or is not permitted by the laws of the Commonwealth, State or Territory to undertake that service or treatment.  Professional confidentiality must be maintained except where the laws of the Commonwealth, State or Territory determine otherwise. It is the obligation of audiologists to ensure that auxiliary personnel observe this confidentiality.  Ensure you provide patients with clear information about their ear and hearing condition and proposed treatment options so that patients can make an informed decision about their treatment.

Read through the responsibilities listed above once again, this time reflecting on how they will affect how you carry out your duties, eg, hearing assessment and hearing aid fitting.

Patient complaints Complaints may be directed to the following bodies:  professional society—ASA or ACAud  Office of Hearing Services  Office of Fair Trading  Ombudsman  Anti-discrimination Board  the courts via a solicitor.

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When can you refuse to treat a patient? This area is not very clear-cut.

Consider this example:

One afternoon as Sue was about to test a client’s hearing she hears a commotion at the front desk. A man is insisting that he has to have a hearing test that afternoon and the receptionist keeps telling him that the clinic is fully booked. Sue asks the man what is wrong and he says that he has noticed over the past few months that he cannot hear properly anymore. Sue tells him that there is another clinic and even a hospital in the next suburb. The client says that parking will be a problem. She tries to get him to agree to an appointment for the next day but he says that he does not want to come all the way there again tomorrow. Sue empathises but, as she looks at the waiting room full of clients, she firmly tells the man they really cannot see anyone else that afternoon…

The right to refuse to see a patient is not always straightforward. In this example, it was not an emergency. It was inconvenient for the man to return the next day.

If it is an emergency, you have to treat the patient.

If it’s not an emergency, you can say that you cannot treat them but you need to tell them where they can go and seek alternative care. You cannot refuse to treat them just because of their gender, race, sexuality, disability, religion, etc — as to do that would be discrimination.

Visit the website of the Audiological Society of Australia, and read through Section H on operating procedures in the code of ethics (locate this through 'The Society'): www.audiology.asn.au/ or go to the section on the code of ethics in the Australian College of Audiology website http://www.acaud.org/menu/ethics.htm

Reflect understanding and compliance with duty of care and legal responsibilities Legislation, regulations, and common law steer the way in which we as workers perform our professional duties in the workplace.

Legislation

Legislation refers to rules and regulations that have been passed in Parliament (either State or Federal) and have become law. Legislations

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clearly define what is legal or illegal and as a consequence there are serious sanctions applied if they are not adhered to. An example of legislation is the Occupational Health and Safety Act.

Common law

Common law, by contrast, refers to judge-made laws. These are laws whereby a decision about guilt is not bound by Acts of Parliament but rather by looking at legal precedence (what decisions have been made previously by a judge), and looking at community attitudes and expectations.

In the health services, common law is framed around duty of care requirements. This means that a worker has a responsibility to provide appropriate standards of care to clients, and a responsibility to assist in maintaining a safe working environment for colleagues and clients. Decisions about worker negligence are related to community standards of what is fair and reasonable care. This is, of course, far more open to interpretation than an Act of Parliament (legislation).

Policy

A policy is a set of principles adopted by an individual, group, or government. For example, a health centre or hospital would have a policy on occupational health and safety.

Procedure or protocol

A procedure or protocol is the correct method of doing something. Examples are a hand washing procedure or needle safety protocol.

Standards

Standards are guidelines or principles, which dictate and describe how specific legislation should be applied. They are a statement about how services should be delivered in the community and a statement about what clients should expect from service delivery. They are a level of quality or excellence attained and accepted as the norm.

Guidelines

A guideline is an official recommendation on how something should be done and what action should be taken in a particular situation, for example, infection control guidelines.

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A substantial part of your job is based on the policies and procedures of the practice where you work. The organisation's management has systems in place to identify and ensure compliance with all relevant legislation, regulatory requirements, professional standards and guidelines.

These policies and procedures are based on current legislation and on the aims of the organisation and all staff are expected to comply with them. If a staff member does not comply with policies of the practice, it may be considered as a breach and disciplinary action may be taken in line with legislation that applies. When there are any changes to legislation, standards, regulations or guidelines, management will reflect these changes by also implementing changes to policies, processes and practices as necessary.

What is the purpose of legislation and law and why is it important for workers to be clear about this?

Laws tell us how we must work. In the health services there are a number of rules and regulations that relate to client care, consumer protection, privacy, and how services are provided in the community and in health settings. These are in place to ensure that the rights and safety of clients and workers are upheld, and so that a consistently high quality of service is provided at all times.

The following terms describe the process of applying legislation and law to service delivery:

Statutory Legislation and Acts that have been passed through Parliament. requirements If a legal obligation is statutory it means that there is an Act which outlines what we should do in given situations. One can be legally punished if the Act is not followed, for example, in NSW it is a statutory obligation for health services workers to report situations where a child is at risk of harm. Regulatory Standards or rules on how a service should be run in order to requirements meet the needs of clients safely and effectively whilst ensuring at all times that clients are able to have control over their own lives. Regulations The details of how to make the broader directions of a particular Act work in practice. The statutory and regulatory requirements contained in Acts and regulations shape community service organisations’ policies and procedures. They guide your decisions about what is “right” in regard to your clients in the same way that road rules provide clear instructions about how we should drive safely so that others are not put in danger.

To summarise, key statutory and legislative requirements are your legal obligations to your clients. They are:

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 contained within Acts and regulations and carry obligations for workers – they inform workers of what they must do in order not to break the law  punishable by law if not followed  very clear about what is expected of you in particular work settings.

Duty of care

Duty of care is a difficult term to define as there isn’t a legal definition of the concept (except in occupational health and safety legislation). Duty of care comes under the legal concept of negligence, and negligence belongs to the domain of common law. There hasn’t been an Act of Parliament passed defining what is legal or illegal but rather the decision is based on what is considered appropriate or not appropriate at a particular time in history.

Duty of care refers to the obligation to take responsible care to avoid injury to a person whom, it can be reasonably foreseen, might be injured by an act or omission. A duty of care exists when someone’s actions could reasonably be expected to affect other people. If someone is relying on you to be careful, and that reliance is, in the circumstances, reasonable, then it will generally be the case that you owe them a duty of care. You need to be clear about exactly what the nature of the care or support is that you are providing, and on which the person is relying. Failure to exercise care in that situation may lead to foreseeable injury (in other words it could have been avoided with due care taken).

Standard of care

Standard of care refers to what is expected of any other reasonable person/worker who performs the same duties. This is not about having to be the perfect worker but about being good enough and doing your job as well as any other worker. Judges when making their decisions regarding whether or not a worker has failed to provide a reasonable standard of care look at many factors such as:  training that the worker has received  laws and regulations  practicalities relating to the situation  needs of others in the situation  current trends in the industry  community values and attitudes.

Duty of care can arise in all aspects of life, not just in community support services.

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Activity 1

The following scenario illustrates the application of duty of care in a broader sense.

Mike runs a small hearing business. He notices that an ear mould on a hearing aid has a sharp edge when it is returned after repair by the manufacturer. Rather than return it to the manufacturer for rectification, he gives the hearing aid to the audiometrist to fit on the client, Susan. Susan badly cuts her ear on the sharp edge of the ear mould. She threatens legal action against Mike.

Did Mike owe Susan a duty of care?

______

Feedback is provided at the end of this topic.

Refer breach or non-adherence to standard procedures or adverse event to appropriate personnel When you recognise that another worker is behaving unethically, it is appropriate for you to discuss this with the worker directly. If that is not successful you may need to report the unethical conduct to someone in higher authority, such as a supervisor, coordinator, or director. This can be a very difficult situation, especially if it involves another team member or a colleague who you respect.

When reporting unethical conduct you need to be clear about:  who was involved  when the incident(s) occurred and who was present  the grounds on which you believe the conduct to be unethical  what actions you have taken (such as speaking directly to the worker or supervisor)  policies and procedures – you need to follow protocol when making a report in order to direct your concerns to the most appropriate person.

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You need to document details of the unethical behaviour clearly and professionally. You also need to clearly document the course of action you have taken and the reasons for that course of action.

If you are not sure what to do, always speak to your supervisor or another appropriate staff member. Remember that it is important to look after yourself and keep yourself safe in all situations. If you need support, ask for it!

If the person you reported the incident to does not take action or support you, you should report the incident to another manager, an external complaints service such as Health Care Complaints Commission (HCCC) or an advocacy service.

There are many ways unethical behaviour can be reported, including;  speaking with someone face-to-face  documenting in the progress notes  writing a note in the communication book  writing a letter  sending an email.

It is important to build an atmosphere of trust and respect in the workplace by:  encouraging openness and tolerance between colleagues  accepting people’s right to hold different points of view  using constructive methods of conflict resolution  maintaining appropriate confidentiality  applying a willingness to be a ‘team player’ – do your fair share of the work!

Maintain confidentiality of client matters

Informed consent

All procedures are to be undertaken with the client’s informed consent. This may necessitate a signed record of consent that is kept with the file of the client’s records.

There are two basic strategies that must be observed to maintain patient confidentiality:  there should be no discussion of any matters related to clients or their treatment with third parties at work or outside of the workplace

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 all written documents relating to patients should be so controlled that the information they contain is not seen by unauthorised people.

Patient’s rights

Patients have expectations when they visit a health facility. Not only do they want to feel important and be listened to, it is expected that you:  accept the different cultural and socio-economic backgrounds of your patients  try to recognise the different needs your patients have  make your patients feel as comfortable as possible. For example, if they are anxious about being screened and treated, talk to them and offer reassurance  no matter what kind of personality or mood your patient may show, always remain pleasant and be understanding. For example, if a patient snaps at you or is abusive, this may be a reflection that he/she is having problems at home or is showing anxiety about treatment. Never take it personally!  ensure that you protect the health of your patients by always following infection control guidelines  always present with a neat clean professional appearance  help to educate patients in the values of preventive care.

Your own example and enthusiasm will set a good example. Smile and be relaxed.

Show respect for rights and responsibilities of others

Working with people from culturally diverse backgrounds

About 25% (one in four people) of the Australian population was born overseas. It is important to remember that in 1788, 100% of the people who lived in Australia were Indigenous people. Indigenous people now make up around 2.4% of the population. It is easy to see from these statistics that a very large proportion of Australians come from a migrant heritage.

A multicultural society is one that not only recognises but actively encourages people from a variety of backgrounds to retain their language

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and culture. However, culture is not just related to immigration. It is about the knowledge, values and beliefs of a society.

When working with people from a similar background, there is a shared language, similar gestures, and a shared understanding of the dominant cultural values. People are more likely to be familiar with culturally appropriate boundaries such as knowing when to shake hands or touch or not touch.

Different cultures have evolved differently, based on different political, social and religious histories, adaptation to different climatic and environmental conditions and types of food available, as well as availability of resources for economic development. Different cultures also have different ways that people relate to each other, ways of expressing feelings, using gestures, and protocols for communication, for example people from Mediterranean cultures kiss once on each cheek when they meet but Asian culture are more inclined to nod or bow.

Working with people from different cultural backgrounds can mean that you need to be aware of possible cultural differences, and respond in a culturally appropriate manner whenever possible. If you are not sure of the meaning of certain actions or gestures you might need to clarify with your colleague or supervisor.

Think about how cultural diversity is promoted in an organisation you belong to, eg a TAFE college, community group or workplace. Do you think this could be improved? What suggestions would you make if you could?

Discrimination

Two general types of discrimination are direct and indirect discrimination. Direct discrimination is easy to see since it is clearly unfair (eg refusing to serve a person be cause of the colour of their skin).

Indirect discrimination is harder to see. It results from having a rule or situation that is the same for everyone, but this makes it unfair for some groups of people (eg to require everyone doing a certain job to be above a certain height, even though this is not necessary to perform the job role).

It is also important to understand that some discrimination, while it is unfair, is reasonable. This may be for reasons of public or personal safety.

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Activity 2

Decide if the following are examples of reasonable or unreasonable discrimination.

1 Not to issue a driver’s licence to a person who is blind.

______

2 Not to modify a training course to meet the needs of a learner with an intellectual disability.

______

Feedback is provided at the end of this topic.

The law

Discrimination is against the law in Australia. It is illegal to discriminate in relation to a person’s sex, marital status, race, religion, age, sexual orientation, transgender status or disability.

As a worker you must ensure that you demonstrate a non-discriminatory approach to your work—in relation to both clients and other workers. If you practise discrimination then a complaint may be filed against you with organisations such as the NSW Anti Discrimination Board, or at a Federal level The Human Rights and Equal Opportunity Commission, who have the authority to hear and deal with these matters.

Both these organisations have websites that can provide you with additional information about these issues:

Human Rights and Equal Opportunity Commission at: www.hreoc.gov.au

NSW Anti Discrimination Board at: www.lawlink.nsw.gov.au/adb.nst

The video Working on Rights (produced by the Redfern Legal Centre) gives an excellent summary of discrimination and what can be done to counter it. This video is available through the TAFE library system or through the State Library of NSW. To borrow material from the State Library you will need to go to your local library and ask them to apply for it on inter-library loan. Your library may charge you a small fee for this service.

Reflect current working knowledge and understanding of employee and employer rights and responsibilities The relationship between employer and employee is affected by laws that control conditions of employment such as rates of pay, working conditions, and other matters.

It is important for you, as a member of a team, to be aware of the role each professional and industrial association plays.

The rights and duties of employees and employers

Employer responsibilities to the employee

The management has the following responsibilities to the employee:  make work available to you (the audiometrist)  continue to pay your wage even if no work is available  pay wages for the period of time you are absent from work due to illness  take reasonable care for your safety as an employee, for example, having safe working conditions and surroundings, as laid down by the Occupational Health and Safety Act  do not expect you to carry out any duties not related to your position  keep a record of the hours worked, wages paid, sick leave and holiday pay, and so on, which should be available to you on request  develop and implement occupational health and safety practices and disseminate information to staff.

Employee responsibilities

You must:  be ready and willing to work if work is available  arrive at the clinic on time and work the agreed number of hours  carry out duties in a competent and careful manner  follow the audiologist's lawful instructions  behave properly at work  be faithful to the audiologist by keeping any practice matters pertaining to patients or finances confidential

 let the audiologist know of all money and property received  inform the audiologist of any matters that affect the smooth running of the practice.

Employee rights

Areas in which you are protected are:  award rates and conditions  unfair dismissal  sexual harassment  affirmative action and equal opportunity  occupational health and safety  the right to join (or not to join) a union  the right to a safe and pleasant working environment.

Your rights as a worker are directly related to your responsibilities as an employee, to the kind of behaviour which your employer, (who also has rights) is entitled to expect.

Elements of a contract of employment

Enterprise agreements

It is now possible for you to negotiate with your employer an employment agreement (contract) which meets specific needs of the profession in which you are working. This is called enterprise bargaining and it results in an enterprise agreement. This is a legal document which must be registered with the Department of Industrial Relations.

You may contact the Department of Industrial Relations for a copy of their document, Enterprise bargaining in NSW.

Before entering such an agreement it is important for you to fully understand the agreement you are entering into, therefore you should seek advice from a solicitor or, if you are a member, the Audiological Society of Australia.

It is important for you to understand the difference between working hours for a full-time employee, casual employee and a part-time employee. Full- time employment involves working 40 hours or less per week. Part-time employment involves working 20 hours or more per week, and casual work is less than 20 hours per week. Full-time employees who work more that 40 hours per week are entitled to overtime payment.

Remember, anything that reduces the award conditions is illegal. Enterprise agreements allow variations that may suit both you and your employer. The Department of Industrial Relations and a Judge of the Arbitration Court should approve enterprise agreements. This sounds threatening but is, in reality, quite a simple procedure.

Enterprise agreements must include the following:  They must specify a fixed term. This is not less than 12 months or more than 3 years.  They will remain in effect after the expiry of the specified term, until such time one of the parties gives notice of termination.  They may be terminated by any party to the agreement, after the expiry of the specified term, by giving 3 months notice to the other parties.  They require the mutual agreement of all parties where termination of the agreement is desired before the expiry of the specified term.  They require written notice of termination to the Industrial Register.  They require 65% approval in a secret ballot of people to whom the agreement applies for the termination to be effective. This operates in cases where a secret ballot was used to approve the agreement.

Roles and responsibilities under Workers Compensation Legislation

A worker who suffers a work-related injury which results in permanent impairment or the loss of earning capacity, or who requires medical treatment after an injury can claim worker’s compensation.

Compensation is paid for:  loss of wages due to time off work  permanent loss of part of the body, or loss of use of part of the body  medical, ambulance, hospital, rehabilitation and some travel expenses  damage to clothing and artificial aids such as glasses, false teeth and artificial limbs  ‘pain and suffering’.

If a person dies as a result of a work-related injury, compensation is paid to his/her dependants as well as funeral expenses.

The Workplace Injury Management Act and the Workers Compensation Act 1998 introduced a system of compensation intended to resolve disputed claims quickly and to emphasise the return to work of injured workers.

Workers compensation legislation in NSW is administered by WorkCover NSW.

Injured workers and their employers have roles and responsibilities under NSW Workers Compensation legislation.

Roles and responsibilities of the employer

An employer’s obligation is to:  have a current workers compensation policy with a licensed insurer in NSW  develop a Return to Work Program  notify the employer’s insurance company within 48 hours of becoming aware that the worker is likely to be away from normal duties for more than 7 days  report injuries to insurance company within 7 days  develop an injury management plan for the individual worker in consultation with the doctor, the insurer and the worker.

In addition, the employer has certain legal obligations to:  keep correct records of wages paid to employees  keep the copies of workers compensation policy for at least seven (7) years from its expiry  have an approved summary of the workers compensation legislation displayed in a conspicuous place where it can be conveniently read by a person employed there, and provide information about the Occupational Health and Safety Act.

Employee responsibilities

As an injured worker, you have an obligation to:  report injuries to your employer or supervisor as soon as possible after injury, and before you voluntarily leave the employment where the injury occurred  attend a doctor to obtain a WorkCover medical certificate if you wish to claim a loss of wages, medical expenses, or damage to personal property  cooperate in any injury management plan.

Find out about the workplace relations system in Australia.

Begin by visiting the websites listed below.

Workplace Authority (Australian government): http://www.workplace.gov.au/workplace/Publications/News/Theworkplacer elationssystem.htm#booklet

Health Services Union of Australia: www.hsu.net.au/campaigns/yourrightsatwork/resources/1124853039_21377. html/

WorkChoices (Australian federal government): www.workchoices.gov.au/

Workplace Authority (Australian federal government): www.workplaceauthority.gov.au

Australian Council of Trade Unions (ACTU): www.actu.asn.au/AboutACTU/default.aspx

Glossary (ACTU): www.worksite.actu.asn.au/showall.php3? secid=12&workst_Session=4fb8b29cda6e360cba198982d25a85de

Recognise, avoid and/or address any conflict of interest

What is a conflict of interest?

A conflict of interest is a situation in which someone in a position of trust has competing professional or personal interests. These competing interests can make it difficult to carry out your work in an impartial way.

The following is taken from a NSW Department of Health circular:

Conflict of interest exists when it is likely that an employee could be influenced or could be perceived to be influenced, by a personal interest in carrying out their public duty. Conflicts of interest that lead to partial decision making may constitute corrupt conduct. (Source: NSW Department of Health File No 04/1711. Circular No 2005/4. Issued 14 January 2005. www.health.nsw.gov.au/policies/PD/2005/PD2005_469.html

Further, under this Code of conduct, you, as an employee, have the following responsibilities:  Do not accept gifts from individuals. Gifts might include free meals, travel etc. However, if you think that by not accepting the gift, you’ll be offending the person, then accept the gift—but make it clear to

the person that you are accepting the gift on behalf of the unit or health service. Also make sure you report the receipt of the gift.  You need to treat everyone as well as every organisation equally and not show preference of any over others.  If you think that you are facing a situation where there is conflict of interest (or where such a situation may arise), then let your supervisor know.

Here are examples of improper actions:  Cathy, a purchasing officer, orders from a supplier who is her uncle. She does not get quotes from other suppliers to see who has the best prices.  Kim, who is supposed to get quotes from printers for the printing of his organisations calendars, pamphlets etc, goes to free lunches with the owner of a printery.  Bob, a supervisor, gives his friends the first choice when rostering work and allocating duties, thus disadvantaging the other workers.  Lee, a supervisor, gives his friend various opportunities (eg the opportunity to act in higher duties and training opportunities), at the expense of workers who are equally deserving or more deserving.  John receives a short supply of goods from a firm owned by his friend — but pays for the full supply. This is not just an improper act. It is a criminal act.

Can you think of an example in your workplace where conflict of interest could arise?

Here is a specific example in hearing services: there are real problems when manufacturers of hearing aids and equipment offer lunches, dinners and gifts to clinic owners and hearing services staff in an effort to influence purchasing decisions.

The information on conflict of interest (above) is from a NSW Department of Health circular:

NSW Department of Health File No 04/1711. Circular No 2005/4. Issued 14 January 2005. www.health.nsw.gov.au/policies/PD/2005/PD2005_469.html

Summary In this topic, we looked at the importance of conducting ourselves in an ethical way in the workplace. The principles of being ethical include respect, accountability, honesty, integrity, equity, empathy, exercising duty of care, and taking care not to have any conflict of interest.

Feedback to Activities

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Mike owes Susan duty of care. Even if he had never met Susan, he should have been able to foresee that someone would use the repaired hearing aid, and that the way it was manufactured would harm them. Because Susan was the wearer of the hearing aid, Susan became the person to whom Mike owed a duty of care.

Feedback 2 feedback 1 Not to issue a driver’s licence to a person who is blind—Reasonable. We do not have the technology to enable a blind person to drive a car safely. 2 Not to modify a training course to meet the needs of a learner with an intellectual disability—Unreasonable. We have the educational expertise to teach many people with intellectual disabilities a great many skills. They have the same rights as the rest of the population to receive learning and achieve their potential.