Problem A senior nurse in the pulmonology department refused for two months in a row to undergo a periodic medical examination and provided certificates of satisfactory health from other medical institutions in the city. The nurse was initially reprimanded and then deprived of her annual performance bonus by facility orders for her refusal to comply with medical examination requirements. Eight days after the last reprimand, the nurse was fired. Questions to the Problem: 1. Is the administrat ion's action in declaring a reprimand lawful? 2. Are there grounds for dismissal? 3. Write an algorithm of actions to be taken by the institution's administration in this case.

1. Yes, the administration's action in declaring a reprimand is lawful. It is common for organizations to have policies requiring employees to undergo regular medical examinations to ensure they are fit to perform their duties. Refusing to comply with such requirements can be considered a violation of company policy, and appropriate disciplinary action, such as a reprimand, can be taken.<br /><br />2. Yes, there are grounds for dismissal. The nurse's refusal to undergo a periodic medical examination, despite being given a reasonable opportunity to comply with the facility's requirements, constitutes a violation of company policy. Furthermore, the nurse's behavior of providing certificates of satisfactory health from other medical institutions in the city instead of complying with the facility's requirements indicates a lack of respect for the facility's policies and procedures. The nurse's subsequent termination of employment after being reprimanded and deprived of her annual performance bonus is justified.<br /><br />3. Algorithm of actions to be taken by the institution's administration in this case:<br /><br />a. Verify the facility's policy on periodic medical examinations and confirm that the nurse was aware of the requirement.<br /><br />b. Issue a written warning or reprimand to the nurse for failing to comply with the facility's policy on periodic medical examinations.<br /><br />c. Deprive the nurse of her annual performance bonus as a consequence of her non-compliance with the facility's policy.<br /><br />d. Monitor the nurse's behavior and performance over a specified period to ensure compliance with the facility's policies and procedures.<br /><br />e. If the nurse continues to refuse to undergo periodic medical examinations or fails to comply with the facility's policies and procedures, consider termination of employment and take appropriate legal action if necessary.<br /><br />f. Document all actions taken and communications with the nurse regarding the periodic medical examination requirement and the consequences of non-compliance.<br /><br />g. Review and update the facility's policies and procedures to ensure compliance with applicable laws and regulations and to promote a safe and healthy work environment.