A practical nurse s handbook to working life

A practical nurse s handbook to working life

DEAR PRACTICAL NURSE, Working life rules can be complex and even difficult at times. The employee and the employer both have rights and obligations towards each other. You should be familiar with these matters as it helps you to avoid difficulties. You can focus on your valuable work as a practical nurse when you know that your employment is built on a solid foundation. SuPer works to ensure its members well-being at work, but it is still a good idea to actively supervise employee interest at your own workplace. I wish you all the success in working life! Silja Paavola Chairperson Finnish Union of Practical Nurses, SuPer THE PRACTICAL NURSE S PLEDGE As a practical nurse, I pledge to practise my profession respecting human dignity and promoting the quality of life of my client. I pledge to support human growth and development, to promote independence and a person s ability to function to promote good health, and to take care of the sick. I pledge myself to take care of those in need, to the prevention of social exclusion, to the alleviation of human suffering, from the beginning of life until its end. I pledge to adhere to the code of ethics of the nursing profession and to honour confidentiality, to develop my professional skills, and to promote the well-being of both myself and my colleagues. I promise to contribute to the development of my workplace and that of the health and social care sector. CONTENTS OF THE HANDBOOK MY DUTIES AND RESPONSIBILITIES AS A PRACTICAL NURSE... 4 Practical nurse as a social services and health care professional... 4 Ethical responsibilities of the profession... 4 Making and maintaining patient records and the confidentiality of information they contain... 5 Confidentiality... 5 Using a protected occupational title of a health care professional... 6 TERHIKKI, the central register of health care professionals... 6 Using your skills... 7 Pharmacotherapy is a part of a practical nurse s job... 7 Continuing education for social and health care personnel... 8 WELCOME TO WORKING LIFE!... 9 Employee rights and responsibilities... 9 Employer rights and responsibilities... 9 Employment contract... 9 Duration of employment contract... 10 Trial period... 11 Collective agreement... 12 Shop steward... 12 Pay... 12 Working hours... 12 Annual leave... 13 Illness... 14 End of the employment relationship... 14 Unemployment benefits... 15 COLLECTIVE AGREEMENTS APPLICABLE TO NURSING... 15 ESSENTIAL LABOUR LEGISLATION FOR EMPLOYEES... 16 NEW EMPLOYEE S CHECKLIST... 18 Copyright SuPer ry

My Duties and Responsibilities as a Practical Nurse PRACTICAL NURSE AS A SOCIAL SERVICES AND HEALTH CARE PROFESSIONAL ETHICAL RESPONSIBILITIES OF THE PROFESSION The purpose of work of a practical nurse, a health care professional, should be supporting and promoting health, preventing illness, taking care of the sick, and alleviating the suffering of clients and patients. A health care professional s responsibility is to apply in his/her professional duties the generally approved, evidence-based working methods in accordance with his/her training. When providing care for a patient, the benefits and possible disadvantages to the patient must be equally considered. A health care professional must always assist those in need of emergency treatment. A health care professional must take into account the legislation pertaining to patients rights. The most important patient rights include the right to good medical and health care and appropriate treatment for the patient s condition, the right to treatment carried out in mutual understanding with the patient, the right to be informed and freedom of self-determination. The patient must be treated respecting his/her human dignity, conviction and beliefs, and privacy and taking into account the patient s individual needs. According to law, customers of social services are entitled to social services of good quality and they must be treated well. The professional ethics of social services professionals include respect for each customer s privacy, freedom of self-determination and the right to participate as well as their conviction and beliefs. No-one should be discriminated against or have their human dignity violated. When carrying out social services duties, the main principle should always lie in the interest of the customer. Ethical principles in social services make it possible for the customer s own views and resources to be brought forward and utilised. MAKING AND MAINTAINING PATIENT RECORDS AND THE CONFIDENTIALITY OF INFORMATION THEY CONTAIN It is a practical nurse s responsibility to document and file patient records as stipulated in the Act on the Status and Rights of Patients. When a practical nurse compiles documents on the examination and treatment of a patient, they are treated as patient records also in the social services sector (in cases like enhanced supported living services, for example). CONFIDENTIALITY A practical nurse may not, without consent, disclose to an outsider any confidential personal information that he/she has learnt due to his/her profession or task of an 4 5

individual or the family of an individual (such as medical condition or economic position). The confidentiality obligation continues even after the person no longer practices the profession. USING A PROTECTED OCCUPATIONAL TITLE OF A HEALTH CARE PROFESSIONAL The title practical nurse is a protected occupational title of a health care profession. In accordance with the Decree on Health Care Professionals, the other protected occupational titles are: orthopaedic technician, podiatrist, trained masseur, chiropractor, naprapath, osteopath, psychotherapist, hospital physicist, hospital geneticist, hospital chemist, hospital microbiologist, and hospital cell biologist. Assistant nurse, dental hygienist, chiropodist, trained chiropractic, trained naprapaht, trained osteopath, physiotherapy assistant, children s nurse, hospital and ambulance attendant, practical mental nurse, psychiatric nurse and practical nurse for social and health care are also considered protected occupational titles as stipulated in the Act and Decree on Health Care Professionals. All individuals with adequate training, experience and professional skills are allowed to work in these professions. However, they are not entitled to the use of the protected occupational title. TERHIKKI, THE CENTRAL REGISTER OF HEALTH CARE PROFESSIONALS The Act on Health Care Professionals divides health care professionals into two categories: licenced professionals and protected occupational titles. SuPer has proposed that this division should be replaced with a single registration procedure. Valvira, the National Supervisory Authority for Welfare and Health maintains a central registry on health care professionals, called the Terhikki registry. Registration is subject to charge. At the moment, it is not compulsory for practical nurses to register their information on Terhikki. Practical nurses are usually registered by their school shortly before graduation. SuPer recommends registration to all practical nurses who have taken the basic degree in social and health care. The public version of the central register, called Julki-Terhikki, is available online. You can verify the professional competence of a health care professional on Julki-Terhikki. You can only view a person s year of birth and occupational title by his/her name or registry code. The publicity of this information is based on the Act and Decree on Health Care Professionals. The Board for the Supervision of Health Care Professionals is a part of Valvira s supervisory activities. The Board discusses and resolves matters related to suspending and revoking a health care professional s right to practise his/her profession or to use the title as well as disciplinary matters. USING YOUR SKILLS In social and health care professions, tasks are partly determined based on the skills you have acquired during training and the experience you have gained. Exceptions in the health care sector include physicians and dentist who have been appointed specified responsibilities, including performing medical examinations on patients, diagnostics and prescribing the required treatment. A limited right to prescribe medication has also been introduced for nurses who have received additional training. The Act on Qualification Requirements for Social Welfare Professionals determines the requirements for the various positions in the field of social services. The employer makes the decisions on tasks at each work place. Practical nurses are professionals in social services and health care and possess diverse skills in the many fields of the sector. The individuals should be allowed to use and develop these skills in different ways. This contributes to the professional identity and professionalism of a practical nurse. Individuals should be allowed to use and develop their skills in different ways. PHARMACOTHERAPY IS A PART OF A PRACTICAL NURSE S JOB The command of pharmacotherapy is a key element in a practical nurse s professional skills. The guidebook Safe Pharmacotherapy (issued by the Ministry of Social Affairs and Health in 2005), includes classifications of the responsibilities and duties of the different professionals in social services and health care for a comprehensive 6 7

pharmacotherapy process, from the planning stage to its implementation and followup. At the moment, the practice is that pharmacotherapeutic knowledge must be demonstrated regularly by taking an exam (LOVe) and the practical demonstrations given at work. The pharmacotherapy training and exam are usually taken every five years, but the practices concerning this vary by workplace. The practices governing pharmacotherapy certificates are determined in the pharmacotherapy plan of the workplace. Participation in the exam and the practical demonstrations constitute a part of the social services and health care professionals responsibility to maintain their professional skills. An employee without a valid pharmacotherapy certificate cannot carry out pharmacotherapeutic tasks. CONTINUING EDUCATION FOR SOCIAL AND HEALTH CARE PERSONNEL Health care professionals are obliged to maintain and develop their skills and knowledge irrespective of the unit where they are employed. Social services personnel must also possess the training and expertise needed in the position. The goal of continuing education is to maintain, develop and deepen the professional skills and knowledge of personnel based on the employee s need for training and the basic tasks of the organisation and the development of its operations. Act on Health Care Professionals 559/1994 Laki sosiaalihuollon asiakkaan asemasta ja oikeuksista 812/2000 (Act on the Status and Rights of Social Welfare Clients 812/2000) Decree of the Ministry of Social Affairs and Health on compiling patient documents and maintaining them and other health care-related materials, no 99/2001. Safe Pharmacotherapy National Guide for Pharmacotherapy in Social and Health Care. Publications of the Ministry of Social Affairs and Health. (Abbreviated English version; full version in Finnish). Act on Qualification Requirements for Social Welfare Professionals, 272/2005 Welcome to working life! EMPLOYEE RIGHTS AND RESPONSIBILITIES Employees are entitled to the compensation determined in the applicable collective agreement and the protection provided by contracts and legislation. Employees are entitled to a healthy and safe working environment. Employees must complete their tasks diligently, observing the instructions that the employer has provided within the employer s right to direct work. The employee must, during the employment contract, refrain from activities that compete with the employer s or are harmful to the employer. The employee must refrain from disclosing the employer s trade secrets or professional secrets to a third party. EMPLOYER RIGHTS AND RESPONSIBILITIES The employer has the right to direct work, i.e. to determine what kind of work is carried out, as well as where, how and when. The employer must comply with the relevant laws and contracts and treat all employees equally (prohibition against discrimination). Employers must also see to safety at work and provide employees with guidance and induction to any work-related matters. The employer must provide the employee with an account of the essential conditions of employment, should they not be recorded in the employment contract. EMPLOYMENT CONTRACT An employment contract is an agreement under which an employee undertakes to perform work on the employer s behalf, within the conditions recorded in the contract, under the employer s direction and supervision and receive compensation for it. Matters 8 9

agreed on in the employment contract include, for example, the term of employment, place of work, tasks, working hours, pay, and possible trial period. An employment contract can be entered into in an oral, written or electronic form. A contract can also become valid implicitly when an employer permits an employee to perform work on the employer s behalf. It is recommended that an employment contract should always be made in writing, as it might be difficult to prove what was agreed upon orally on the terms and conditions of the employment contract in the case of a dispute. At SuPer members workplaces, collective agreements stipulate in nearly all cases making employment contracts in writing. The collective agreement applied at the workplace is recorded in the employment contract. The employee has the obligation to explain to the employer the key conditions of the employment relationship in writing. This explanation must be provided for employment contracts with indefinite duration and for temporary contracts of more than one month in duration. An explanation must be provided if an employee has repeatedly made employment contracts for a period of less than one month with the same employee, and with the same terms and conditions. There is no need for a separate explanation if the written employment contract includes information on all the key terms and conditions of employment. DURATION OF EMPLOYMENT CONTRACT Employment contracts are generally written for an indefinite period. This entails a permanent employment relationship. Indefinite employment contracts terminate when one of the contracting parties gives notice or cancels the employment contract with relevant grounds as set out in the Employment Contracts Act. A temporary employment contract is valid for a fixed term. An employment contract can be temporary for justified reasons only. An example of a justified reason for a temporary contract is acting as a permanent employee s substitute. The reason for temporary substitute tasks must always be identified and the reason and duration be recorded in the employment contract. If the employer renews temporary contracts repeatedly without the aforementioned justified reason, the temporary contract can be regarded as an indefinite contract instead. It is not permissible for the employer to give notice to an employee under a temporary employment contract and the same applies to the employee during the temporary contract s period of validity. If conditions on terminating the contract have been agreed upon in the employment contract, it is possible to terminate a fixed-term employment contract in the middle of its period of validity. If several successive temporary employment contracts are made without interruption or with short interruptions only, the employment relationship is considered to have continued uninterruptedly with regard to the determination of employment benefits. Employment benefits refer to such benefits as annual leave and sick pay. TRIAL PERIOD The parties can agree on a trial period at the beginning of employment. The trial period provision can be included to both indefinite and temporary employment contracts. During the trial period, both the employer and employee are entitled to cancel the contract with immediate effect, without observing the period of notice. The cancellation may not take place with discriminatory grounds or grounds otherwise deemed inappropriate considering the purpose of the trial period, such as the employee being pregnant. The purpose of the trial period is to offer both the employer and the employee an opportunity to consider whether the employment contract they have entered into meets the expectations set in advance for work, working conditions, etc. The trial period provision must always be taken seriously, because the threshold for cancelling an employment contract is low during the trial period; the employee does not necessarily have to make a mistake or perform poorly in his/her duties. The trial period is usually no more than four months in an employment relationship and no more than six months in a public-service employment relationship. In a temporary employment relationship of under eight months, the trial period may not exceed half of the duration of the employment relationship. A trial period can usually take place at the beginning of the employment relationship only. If the employer and employee enter into a new employment contract once the contract has expired, a new trial period can be included in the contract only if the tasks of the new employment relationship differ substantially from those in the old. An employment contract is binding on both the employer and the employee! 10 11

COLLECTIVE AGREEMENT A collective agreement is an agreement between a trade union and an employer or an employer representative. The agreement provides the terms and conditions of employment observed in the field of the collective agreement. Collective agreements include provisions on matters such as pay, annual leave, industrial peace and the rules for making companylevel agreements. An employment contract may not include weaker terms and conditions than those agreed upon in the applicable collective agreement. It is a good idea to find out which collective agreement is in use at the workplace before entering into an employment contract. Collective agreements are complied with at practically all workplaces where SuPer members are employed. SHOP STEWARD The shop steward is a SuPer member s most important contact person at the workplace in employment contract matters and supervision of interests. The shop steward is the workplace expert on employment relationships and public-service relationships. The shop steward negotiates any possible disputes concerning matters such as pay or other terms and conditions of employment and makes the company level contracts. Before signing an employment contract, it is a good idea to let your shop steward see it. PAY Minimum pay is determined according to the relevant collective agreement and it must comply with the collective agreement applied at the workplace. You should always find out your pay before you sign an employment contract. The pay, its grounds and pay period must be recorded in the employment contract. WORKING HOURS Working hours include the time the employee uses to perform work duties and the time when the employee is obliged to be available for the employer. In the health care sector, the time of regular working hours and daily working hours are determined in the collective agreements. The working hours are usually divided in a system of period-based work or regular working hours. In period-based work, the hours are determined based on the length of the compensatory period that is applied at the workplace. Usually one period equals three or six weeks. In period-based work, the shifts take place between Monday and Sunday. Period-based work includes morning, evening and night shifts. Regular working hours do not include night work. The shift roster includes the start and end times of the shifts as well as the periods of rest. The employee must confirm the shift roster for the period in question no later than one week before the period begins. Premium pay to be paid for evening and night shifts, Saturday and Sunday work as well as overtime, are determined by the applicable collective agreement. In addition to these, it contains provisions on the arrangement of working hours on public holidays falling on weekdays, daily and weekly periods of rest, and compensation for on-call times and urgent work. ANNUAL LEAVE Annual leave is based on the Annual Holidays Act. Exceptions to the provisions of the Annual Holidays Act may be agreed upon in collective agreements. Depending on the applicable collective agreement, the provisions on annual leave may differ from each other significantly. Leave is eared during the period from 1 April to 31 March. This period is called the holiday credit year. Annual leave is earned according to the number of working months and the number of employment years determines the length of the leave. The holiday must be granted usually during the holiday season that falls between 2 May and 30 September, these dates inclusive. The employer decides on the timing of the annual leave after hearing the employee s opinion. The timing of the holiday can be otherwise arranged if this is agreed upon; and a part of the leave can be saved for coming holiday seasons. According to the Annual Holidays Act, annual leave is earned two days for each month, if the employment relationship has lasted less than a year on 31 March. If the employment relationship has lasted over one year by 31 March, 2.5 days of holiday are earned each month. Some collective agreements include provisions on annual leave that are longer than the law stipulates. 12 13

Holiday pay, equal to the employee s normal pay, is paid for the annual leave. Collective agreements also include provisions on the holiday bonus that is usually half of the holiday pay. When the employment relationship is terminated, a holiday compensation is paid to the employee, i.e. he/she receives a monetary compensation in lieu of a holiday. During an employment relationship, paying a holiday compensation is an exception and comes to question only in certain circumstances that are recorded in the Annual Holidays Act. ILLNESS Collective agreements include provisions on sick pay. There are significant differences in the collective agreements provisions on sick pay. They concern such details as the length of the sick pay period. Providing a medical certificate is usually required in order to receive sick pay. The provisions in the collective agreements and workplace-specific practices may, however, vary. There are workplace-specific rules on who to inform of the absence and how. The employer and employee have the opportunity to agree that an employee is entitled to try out returning to work after a longer period of sick leave with part-time work before the period of incapacity for work ends. In such cases, the employee is entitled to parttime pay and, when certain conditions are filled, to partial sickness allowance from Kela. END OF THE EMPLOYMENT RELATIONSHIP An employment relationship can end by either party giving notice or cancellation. Giving notice means that the employment relationship ends after a period of notice. If an employment contract is cancelled, it will end immediately, without a period of notice. The Employment Contracts Act defines the employer s grounds for giving notice to an employee. The grounds for termination must be proper and weighty, such as neglecting duties. If the employment relationship is terminated on financial and productionrelated grounds, the employee is obligated to try to arrange other duties or training for the employee before terminating the employment relationship. An employee is entitled to give notice without providing any grounds to the employer. When an employer gives notice to an employee, the notice period ranges from 14 days to six months, depending on the length of the employment relationship. When an employee gives notice, the notice period is 14 days in cases when the employment relationship has lasted no more than five years and one month when the employment has lasted longer than five months. When an employment relationship is cancelled, there is no notice period; the termination takes effect immediately. Cancelling an employment relationship is a more severe step than terminating it. An employer may only cancel an employment relationship for an extremely weighty reason, which can refer to serious neglect of work duties or breaches against work orders. The employment contract can be considered cancelled if the employee is absent for seven days without informing the employer. The employee is entitled to cancel the employment contract in the case of the employer s serious breach of employer responsibilities. UNEMPLOYMENT BENEFITS As a SuPer member you are insured against unemployment in the SuPer s unemployment fund. The membership fee of the unemployment fund is included in the SuPer membership fee. To become a member of the unemployment fund, you must have a valid employment relationship when joining the fund. COLLECTIVE AGREEMENTS APPLICABLE TO NURSING Before starting in a new job, you should find out which collective agreement is applied to the employment relationships at the workplace. More information on the provisions of the collective agreement is available from the shop steward for the workplace. 14 15

The most commonly applicable collective agreements in practical nurse jobs: Essential labour legislation for employees General Collective Agreement for Municipal Personnel (KVTES) Collective Agreement for the Private Social Services Sector Collective Agreement for the Health Services Sector Collective Agreement of the Employers Association for Service Enterprises Collective Agreement for Finnish Student Health Services Collective Agreement Regulating TAW of Seure Employees Services OTHER COLLECTIVE AGREEMENTS APPLICABLE IN NURSING POSITIONS: General Collective Agreement for Emergency Care Services Industry Collective Agreement for the Members of Hammaslääkärien työnantajayhdistys (Employers Association for Dentists) Collective Agreement for Plusterveys Dentists Collective Agreement for the Finnish Institute of Occupational Health General Collective Agreement for Central Government General Collective Agreement for the Church Sector It is the employer s responsibility to make the applicable collective agreement and the most important labour laws available at the workplace. ESSENTIAL LABOUR LEGISLATION: Employment Contracts Act Annual Holidays Act Working Hours Act Occupational Health and Safety Act Occupational Health Care Act Act on the Protection of Privacy in Working Life Act on Co-operation within Undertakings Act on Co-operation between Employee and Personnel in Municipalities Study Leave Act Health Insurance Act Act on Job Alternation Leave Employment Accidents Act Act on Occupational Safety and Health Enforcement and Cooperation on Occupational Safety and Health at Workplaces Act on Municipal Officials Young Workers Act Non-Discrimination Act Act on Equality between Women and Men Pay Security Act Employees Pensions Act Local Government Pensions Act Unemployment Security Act Act on Government Employees 16 17

NEW EMPLOYEE S CHECKLIST 1. Join SuPer. 2. Make a written employment contract and agree on a possible trial period. 3. Find out which collective agreement is applied at the workplace. 4. Agree on the tasks, amount of pay and its payment date, possible seniority increments, working hours and place of work in as much detail as possible. SuPer The Finnish Union of Practical Nurses, SuPer is the largest trade union in Finland for social services and health care professionals with an upper secondary level qualification. SuPer focuses on supervising its members interests in professional, financial and contract matters. Practical nurses are SuPer s largest member group. SuPer members work in a many fields and under different collective agreements. Some SuPer member titles are 5. Check the duration of the contract (indefinite/temporary). 6. Find out if there is a shop steward at your workplace. PRACTICAL NURSES ENROLLED NURSES AND NURSE S AIDES CHILDREN S NURSES AND CHILDCARE PROVIDERS CARETAKERS HOME HELP WORKERS INSTRUCTORS CHILDREN S INSTRUCTORS RECEPTIONIST S ASSISTANTS MEDICAL TECHNICIANS AMBULANCE DRIVERS AND ATTENDANTS WARD CLERKS TEACHING ASSISTANTS PERSONAL ASSISTANTS NURSES FOR MENTALLY HANDICAPPED MENTAL HEALTH NURSES MEDICAL INSTRUMENT TECHNICIANS DENTAL ASSISTANTS PHYSIOTHERAPY ASSISTANTS PHARMACY ASSISTANTS AND PHARMACEUTICAL TECHNICIANS LIVING ASSISTANTS REGISTERED NURSES PUBLIC HEALTH NURSES PHYSIOTHERAPISTS SOCIAL SERVICE PROVIDERS SOCIAL SERVICES INSTRUCTORS Helsinki 2015 Copyright SuPer ry 18 19

WORKING CLOSE TO PEOPLE The Finnish Union of Practical Nurses, SuPer is the largest trade union in Finland for social services and health care professionals with an upper secondary level qualification and for students in this field. SUOMEN LÄHI- JA PERUSHOITAJALIITTO SUPER RY Ratamestarinkatu 12, 00520 Helsinki puh. 09 2727 910 faksi 09 2727 9120 www.superliitto.fi facebook.com/superliitto Twitter and Instagram @superliitto