Quote from winzer
During my interview, I answered that I would seek help from my fellow RN colleagues and, failing that, would bring up the issue with the charge nurse. However, I didn't elaborate enough and didn't go so far as to say I would decline the assignment and request reassignment nor did I say I would research it for next time...a pretty so-so response on my part.
Your answer doesn't sound that bad to me. To flat out say that you would not accept the assignment is something that I have never wanted to hear in an interview. What I have wanted to hear is that the Charge Nurse would be told ASAP and that you would seek help from him/her (and or others). The Charge Nurse may decide to change the assignment so that the new grad would not be involved in the care of that patient -- or may be able to juggle the assignments so that the new grad keeps the challenging patient with some extra help being provided by a more senior nurse. But that's the Charge Nurse's call -- not the staff nurse's call.
In real life, there are times when NO ONE knows much about the patient's condition. Sometimes, we are ALL "winging it." Sometimes, no one (including the docs) has a good handle on the diagnosis. We can't ALL refuse the assignment.
I think it is also crucial to use the change-of-shift report wisely in such a situation. Get as much information as you can, ask a million questions -- and ask the off-going nurse to help you talk with the Charge Nurse. Be honest about your lack of knowledge about this patient and ask for his/her help in doing some quick learning -- and in supporting your need to tell the Charge Nurse ASAP.
As someone who has hired lots of nurses in my life -- I have never asked this question. But if I did, I would want to hear that they would enlist the help immediately available (off-going nurse), notify the Charge Nurse ASAP, and be willing to "stay with" the situation to ge the patient the help he/she needed -- even if that meant calling the Nursing Supervisor, etc.. I would not want to hear the applicant say that she would simply refuse to take the assignment without doing these things.