Hi, I work in a 4 bed ICU. Some days I can have 2 pt's. with a CNA. They can be unstable with vasoactive gtts. and/or be intubated as well. I have just sucked it up for this assignment. Today I was with another nurse no CNA and two pt's. No problem with that. The other nurse said the supervisor told her we would be getting a 3 week (preemie, no less) old to rule out for sepsis. I have had no experience, competencies or orientation to take care of a pt. like this. I told the other nurse and she said neither did she. I decided to finish what I was doing (deciphering a page of orders while the doctor who wrote them was still available) and then speak to the supervisor. Well, within about 15 minutes (quicker than I've ever seen at this hospital) the ED was calling to give report. I told them I was refusing that pt. for the reasons stated above. Within 2 minutes the Nurse Manager comes in the ICU and says that the ER said I called THEM and told them that I was refusing and that I am not allowed to refuse an assignment without speaking to her or the supervisor. And besides the baby was just a med-surg pt. and they didn't have enough beds. I tried to explain to her that everything happened so fast I was trying to complete another task and we didn't expect the call for report so quickly. She wasn't listening. The other nurse took the pt. She was scared the whole time because this baby wasn't holding his sat's. When we looked at the orders the admit was for ICU. There were no corrections from med-surg status just the order for ICU. Anyway they transferred the pt. to a PICU at another hospital 5 hrs later. The other nurse later told me that our Unit Manager told her she is not allowed to refuse an assignment. There are no policies in place at this hospital to accept an assignment with reservations. What are your thoughts on this everyone?