Published Oct 1, 2000
Was wondering if anybody has experience using these forms and what the response has been. It sounds like a must do type of documentation to protect a nursing license and would like to recommend that the nurses here begin doing it. But before doing that I would be interested in seeing what type of response it has gotten from the hospitals. Basically what does one need to prepare themselves for.
Thanks in advance.
Genista, BSN, RN
In my union facility, assignmt under protest requires a follow up meeting w/ Nurse who files, and nursing management, union rep. Often, merely the threat of a assignmt under protest is enough to inspire a change in staffing. Sounds like a good idea. It's important to document.
J Nurse Supporter
I have been reading some the things the California Nursing Assoc. has been leading and they are excellent. You are lucking to be working with their representation. It is nice that they are leading the direction of the future for nursing. I think they should be used as a role model for the rest of the states to get similar legistlation passed as in California.
Keep up the good work.
Is the use of these forms that limited that barely anybody uses them? Do all the nurses just continue to take on more and more work regardless of how unsafe it is, risking their license/profession without saying anything.
Who is responsible when something goes wrong? The nurse. Does everybody realize that the defense "It's not my fault, the hospital gave me too many patients" doesn't work? Or is everyone hoping the hospital is going to stand up and support you when something goes wrong? Get real, you will be the cheapest escape goat anybody could hope to find.
Your only defense is to document what is happening in the hospital and that you did everything in your power to make sure that the hospital administration was aware of the dangerous conditions (in writing). Nobody is going to make things better except for you, so you might as well stop waiting.
In our facility, these go through the Quality process just as any incident form would. They also get followed up on through either professional practice or labor/management committees.
When signed by all nurses on a shift the form is very powerful. If only one nurse fills it out without the support of coworkers it can still protect that nurse. The JCAHO asks if the management was warned by staff in the event of a sentinel event. This will make the hospital file a 'Root Cause Analysis' and plan of correction that corrects the system, not blame the individual. This form is proof the staff warned management of unsafe staffing, floating, etc.
LaurieCRNP2002, MSN, RN, APRN
J Nurse Supporter
I have not had the chance to use the form yet but as my facility is changing the staffing algorithm (thus giving each nurse MORE patients! :-(), I plan to use it if I feel my assignment is unsafe. Whether my colleagues would be willing to sign it also remains to be seen. You are so right about the hospital using the nurse as the scapegoat--we will get hung out to dry faster than one can say "lawsuit"! I certainly do not trust anyone in administration to look out for my interests (the one person I do trust is my former manager--obviously she's not there anymore!).
So I will do anything I have to to protect myself, and if it means leaving, that's what I will do.
Our union lawyer encourages that ADO's be filed . If you want changes, you have to file. They are more effective when different people file them instead of the same person, because it shows management there is a real problem. I filed one recently two days in a row about the same problem. It happened over a weekend and on Monday morning action was taken to resolve the problem. Fill the ADO out as soon as possible, it has to be filed before the end of your shift or it will not be of any use. Be sure to make a copy . We were also encouraged to file grievances that violate the contract. If you file a grievance you must cite which article of the contract it violates, and state the remedy that is being sought and the statement that "anything else to make the RN whole." We had a grievance workshop and this is what the lawyer said must be in the grievance or it will be denied.
[This message has been edited by teapot (edited October 15, 2000).]
We have used these @ our hospital for a few years now. Our union reps encourage us to use as appropriate. Many do, w/ some follow-up by management. It is documentation that may help protect your license, should an incident occur. It is less effective after the fact, since management can claim no knowledge of an unsafe assignment. These may also serve of documentation of unsafe staffing/ working conditions during contract negotiations or a strike.
I've never heard of the forms you mention and am new to the list. I'd love to know how to make them available to my fellow RN's as I'm sure they would make great stocking stuffers!!!!!!!!!!!!
As an aside, I would like to know your opinions of what regular staffing consists of and for how many patients? I am currently working on a very busy med/SURG unit in a 750+ bed hospital and normally have 5-6+ patients (w/admissions,postops,er preops, as well as chronic patients awaiting whatever comes sooner) and we frequently have no aid available. Is this the norm for everybody or do you not mention ancillary staff when speaking of the "nursing shortage" or "short staffing"? Yesterday was a typical "day from Hell" and my complaints are always squelched by someone saying that "other hospitals staff for 7-9 patients/nurse". I hope that those other hospitals are also including 2-3 nurse aids to answer bells, etc. Otherwise I'm in a bad place in regards to my carreer!!!!!!!!!
Originally posted by J Nurse Supporter:Is the use of these forms that limited that barely anybody uses them? Do all the nurses just continue to take on more and more work regardless of how unsafe it is, risking their license/profession without saying anything. Who is responsible when something goes wrong? The nurse. Does everybody realize that the defense "It's not my fault, the hospital gave me too many patients" doesn't work? Or is everyone hoping the hospital is going to stand up and support you when something goes wrong? Get real, you will be the cheapest escape goat anybody could hope to find. Your only defense is to document what is happening in the hospital and that you did everything in your power to make sure that the hospital administration was aware of the dangerous conditions (in writing). Nobody is going to make things better except for you, so you might as well stop waiting.
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