Can nurses legally "refuse" to take a new admit?

celticgirl · Apr 21, 2010

Thats an iffy one. If you havent accepted report or care of the patient it may be a job issue more than a legal issue. If you have assumed responsibility and taken report on the patient then its a legal issue. That law is so iffy. That answer is just my opinion. Did you ask another nurse to take the patient for you?

tokmom, BSN, RN · Apr 22, 2010

I have refused, but the pt was borderline icu and my load was heavy. There is an unsafe staffing form that our union has. You sort of get your butt covered by filling it out.

SFRN · Apr 22, 2010

If, for ANY reason, you are not competent to care for a particular patient it is your legal as well as ETHICAL responsibility to refuse such patient by notifying the charge nurse. If the charge nurse assigns the patient and you are not competent to care for patient you NEED to fill out the ASSIGNMENT DESPITE OBJECTION form, this will indicate that you have refused the care for a patient for whatever reason and the patient was still assigned to you. As a charge nurse I WOULD NEVER assign a patient to a nurse that is not competent for that specific patient.

Batman25 · Apr 22, 2010

Yes, you have the legal right to refuse. It is also the professional and ethical thing to do. They shouldn't be threatening or bullying you to comply but I'm not surprised. Many times by bullying and threatening the nurse will accept because they become fearful of their job. If you can't handle another patient stand firm. They will either have to take the patient, get someone else to do so, call an agency or hopefully hire more staff when nurses learn to advocate better for themselves.

Also, taking the patient and signing a form doesn't excuse you from any liability. If anything happens to that patient under your care you are still liable, can still be sued, and your license is still at risk. First thing the opposing attorney will ask is, "Why did you accept the patient knowing you couldn't handle them?" It's a good question and your employer will not back you. Look out for yourself and your patients.

bunsterj · Apr 22, 2010

If you are not union, where would one get the "assignment despite objection" form. I've worked at 2 different hospitals and have never seen or heard of them.

Nascar nurse, ASN, RN · Apr 22, 2010

The OP indicates they are in long term care. The forms mentioned above do not exist in our enviornment.

In LTC, I have never seen the floor nurse be able to refuse an admission. If the floor nurse is truly that overwhelmed that they can't handle it then someone needs to pitch in and help out (whether if from another unit or from nsg management).

The reality in LTC is the whole system revolves around money. Like any business in the world, money must come in or the lights can't stay on, payroll can't be met etc. The money comes in when we admit new residents. If we start telling local hospitals that we can't take "so and so today, we are just to busy" then they send the resident to another facility. If we do that one too many times, the hospital just quits calling with new admission referrals.

ItsTheDude · Apr 22, 2010

yeah, you can refuse and your employer can refuse to keep you working there (employment at will state).

crissrn27, RN · Apr 22, 2010

And most LTC have a certain amount of time (usually 24-72 hours) to do the assessment and other paperwork to admit a resident. You have to have your orders to the pharmacy, and do the MAR, but you usually have more time to complete the other stuff.

wooh, BSN, RN · Apr 22, 2010

yeah, you can refuse and your employer can refuse to keep you working there (employment at will state).

Yup. There's lots of things we can legally do. Doesn't always mean we'll keep our job when we do them.

steelydanfan · Apr 22, 2010

Batman 25 is not correct. Yes, you have the right, and the legal responsibility to refuse an assignment that you know as a professional nurse to be unsafe. The ADO form is your legal recourse to state your objection. Once you have signed and submitted that form, it is up to your supervisor to address the situation. Your signature on that form, and possibly your co-workers (I hope you also involved them as well) is your legal protection against future lawsuits involving nursing malpractice committed by yourself. If you do NOT submit this form in the face of state mandated ratios the state board of nursing will come down on you severely.

RNMLIS · Apr 22, 2010

I used to work both night and evening shift...

I was on the 3-11

We received a new admit - late as usual.

We were supposed to have an inservice on respiratory care for this resident - never happened..

Interesting how 'they' expect/assume that a LTC RN has the skills to handle any 'care' without an inservice/referesher/or support. If the poor nurse manages to make it through the night - management takes the experience as - got away with that one - a negative reinforcement >>> that slippery slope to more and more reckless choices - or on the nurse's back

garanteed If I knew I could refese this patient - I would have lost my job with threats of repercussions and boy oh boy don't expect a reference or If something happened - as i would be out on that plank ALONE

I had been at this LTC/subacute(yeah right) facility for close to 2 years and we never had anyone on a respirator care before...we did not have the equipment on site.

This woman was a mess - seemed like a great gaping hole in her neck where what seemed like an ill fitting trach was attached - needing frequent suctioning needed.

- argumentative combative..

management was still there at 10pm and was of assistance for admission but scurried away just before 11pm.

Luckily the night nurse had prior hospital/respiratory experience

boy was she P**$$3@ - too much to safely handle with 44 other unpredictable residents.

I know I could not have handled it safely - patient was sent out in the early AM..

This former LTC RN thinks most LTC facilities walk a fine line...