How to turn down an assignment

[CrystalSSA]

First let me say that nothing bad happened, but I feel I took a risk at work that I am not willing to take again.

I was given my usual assigment at the start of the day. It is a heavy load, but I can deal with it. I was then told that some people "didnt show up" and that I would have to provide total care on some of my patients for a few hours. Again, it's a heavy load, but I can do it "for a few hours" until they get someone in. "someone" never came.

Then 4 hours into my shift, I was told that a nurse was leaving sick and that I needed to take two additional patients. "Just until they can get someone in".

Again.."someone" never came.

Looking back, even though nothing happened, I felt I took a risk. My state nursing law states that I do not have to accept an assignment that I am uncomfortable with, but it does not say what happens if I refuse (like I've seen TX has a clause for what to do).

How would you have handled the situation? I do not want to get fired, but I will not accept an assignment like that again..EVER.

Should I go to my manager now and express my concerns or wait for it to happen again?

[Morainey, BSN, RN]

Sometimes, when I'm charge, I need to be a bug in the supervisor's ear. Otherwise they "forget" we don't have an aide on nights, and all we get is "sorry..." over the phone when 2300 rolls around. Or a weak, "I called everybody and no one can come in". Don't be afraid to nag! That's my most valuable lesson after 1.5 + years of nursing

[leslie :-D]

if you do say "no", be prepared to either be reprimanded or fired...

esp if it's an at-will state.

i've been in such a situation a couple of times, where my assignment was ridiculously unsafe.

i wrote down the additional pts on the assignment sheet and wrote "accepted under duress".

there wasn't any time to confer with the nm right there and then, but i did have a big pow-wow with her afterwards.

she wasn't happy that i had written what i did, but there was a next time when this happened and i wrote the same thing.

i also made out incident reports both times, as i hadn't thoroughly completed my assignment.

i did this so in the event that anything went wrong, it was noted that my back was to the wall and there was no other choice (unless i wanted to risk being fired).

do what feels right to you.

in the meantime, i would consider looking elsewhere for a job that doesn't treat its employees like workhorses.

good luck to you.

leslie

[salvadordolly]

When I was a new grad, I turned in one of those unsafe staffing reports to my DON (in writing). They never let me live it down. They picked at me and then fired me for something petty. I've never done it again. I just try to negotiate like some of the other poster's said. If a unit is habitually badly staffed, I'd just get a different job.

[psu_213, BSN, RN]

On the unit on which I used to work (nights) there was a similar situation. One nurse called off, not replaced, no "promise" of a replacement. When the night shift nurses came in, they each had 4 patients and the deal worked out by the manager and the day shift nursing supervisor was that they would get no more than 5 patients each. Well, no one mentioned this deal to the night shift supervisor, she dumped on them, and by 7 am, each nurse (there were 3 of them) had 8 patients.

Those nurses voiced concern to the supervisor (including "our licenses are on the line"), and they response from the supervisor was basically "too bad, due to factors outside my control, I have to send these patients up here"--which, at least to some extent, probably was true.

My question is this: what right does a nurse have to "refuse" a patient? Does the charge nurse or a staff nurse on the floor have the right to refuse an admit from the ER that has been assigned by the supervisor? Or, does this vary state to state?

[MN-Nurse, ASN, RN]

How would you have handled the situation? I do not want to get fired, but I will not accept an assignment like that again..EVER.

I put my head down, power through it and find another job as fast as I can.

[Caffeine_IV]

It seems that you cannot do this without risking your job which we need and replacement jobs take months to find these days.

I haven't started with an unsafe assignment but we have been slammed with admissions without adequate staffing which is just as bad. We had 8 and 9 patients by end of one hectic night.