During a nurse's interview for a new job, the health benefits are ...

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During a nurse's interview for a new job, the health benefits are described as being provided by a health maintenance organization (HMO). What should the nurse expect from this coverage?
 
  1. The nurse will have to choose a provider from within the HMO.
  2. The nurse can obtain services from a nonparticipating provider and the HMO will pay for a portion of the charges.
  3. For an additional premium, the nurse can choose any provider.
  4. By joining this HMO, the nurse is entitled to unlimited treatment and services.

Question 2

A nursing assistant tells a nurse, I am going to have to call in sick tomorrow because I don't have a babysitter. How should the nurse respond to this information?
 
  1. The assistant's sick time is earned and should be used in any way the assistant wishes.
  2. The assistant should use personal time, not sick time for this situation.
  3. The assistant's absence will not be a major problem for the unit as long as only one day is missed.
  4. It will be okay for the assistant to miss a day because it will help another assistant get overtime wages.

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Answer to Question 1

1
Rationale 1: An HMO is a geographically organized system that provides an agreed-upon package of health maintenance and treatment services. Providers must be chosen from those in the HMO.
Rationale 2: The HMO system will not pay for services provided out of network.
Rationale 3: The ability to choose a provider who is out of network for an additional premium is a feature of point-of-service plans.
Rationale 4: The HMO provides an agreed-upon package of health maintenance and treatment services. Treatment and services are not unlimited.
Global Rationale:

Answer to Question 2

2
Rationale 1: Misuse of sick time has a negative impact on the unit's finances and perhaps on the quality of care provided.
Rationale 2: Most facilities award personal days that should be used for situations such as this.
Rationale 3: The nurse does not know how much impact the assistant's absence will have on the unit.
Rationale 4: It may be helpful for the assistant to get overtime wages, but it is not for the good of the unit.
Global Rationale:

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Thanks for the timely response, appreciate it

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TYSM