Based on their professional and ethical obligations, registered nurses have the authority to accept, refuse, or oppose in writing any patient assignment that places patients or themselves at substantial risk for harm, according to the American Nurses Association (ANA). Registered nurses have the professional duty to report concerns with any patient assignment that puts patients or themselves at risk for injury.
The Nursing’s Social Policy Statement (ANA, 2003), the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001b), Nursing: Scope and Standards of Practice (ANA, 2004), as well as state laws, rules, and regulations governing nursing practice, serve as the foundation for the registered nurse’s professional obligations to protect patients.
It’s one thing to be assigned to a clinical setting that you are unfamiliar with, but what if you are required to carry out a duty that is outside the purview of nursing practice? When should you decline a task?
Respect For Nurses
Too few staff members and too many patients. In today’s hospitals, that is a typical scenario. Additionally, it’s a place where erroneous and floaty assignments, given without any respect for nurses’ (lack of) experience or training, are common.
It can be terrifying to be given charge duty in the ICU, for example. If you haven’t looked after ventilator patients in a long time. Being required to carry out a duty that is beyond the scope of nursing practice or an unknown process might be much more dangerous for both the patient and the nurse.
The optimum course of action will be decided by the circumstances. Refuse the assignment if you are certain that the hospital policy or state Nurse Practice Act prohibits RNs from carrying out the necessary duties. For example, your state’s legislation bars even competent enterostomal nurses from conducting wound debridement, despite other states’ allowing it. But what if you’re not sure?
Should a Nurse Refuse a Patient Assignment?
Patient acuity has grown, and clinical nurses’ patient care assignments are now more time-consuming due to the current state of healthcare. When is turning down a patient assignment permissible for an RN?
Facilities are raising the nurse-patient ratios as a result of the lack of RNs in the country. Which adds to the workload and patient load for nurses. Today, an average assignment in critical care units contains three patients more often than it did in the past when there were one or two patients per nurse. Each RN may generally be assigned six, seven, or eight patients on the telemetry and med-Surg units. The sensation of frustration and the idea that the task would never be accomplished is one that nurses frequently experience under similar circumstances.
Motives For Rejecting a Patient Assignment
- lacking the knowledge and expertise required for the task. This is the reason, everyone prefers to get cheap assignment writers for their tasks.
- activities are taken by nurses that are not covered under the state’s nurse practice statute. The nurse really has a legal obligation to decline the assignment if it entails nursing responsibilities that are outside the purview of the state’s nurse practice statute. Or else they risk being disciplined by the state board of nursing.
- The health of the nurse or her unborn child is in danger.
- inadequate unit orientation, particularly with reference to emergency devices, endangers patient safety.
Alternatives For Rejecting an Assignment
The chain of command must be followed when communicating an evaluation that the task endangers patient safety. And the nurse must contact the nursing supervisor right away. Additionally, it is advised that the nurse put this in writing as well, maybe by in-hospital email. So that there is documentation of the event in case it becomes important in the future.
The issue of patient desertion is the nurse’s alternate choice. When the nurse declines to care for the patient and no one else is available. It is considered an act of neglect and constitutes abandonment. A nurse-patient relationship and a responsibility to care for the patient or patients are necessary for patient desertion.
Prior to declining to care for the patient after receiving a report on the patient and accepting a patient assignment. Other arrangements for the patient’s care must be arranged. If a nurse departs in this circumstance, the nurse is likely to lose the case for patient abandonment. Before a nurse declines or discontinues patient care, patient care must be transferred.
