Can I Refuse?

kids · Sep 17, 2003

I would recommend doing a search on any (or multiple) search engines with the topic "nursing ethics" that should give you more sources than you hoped for.

colleen10 · Sep 17, 2003

Off the top of my head I would suggest taking a looking at your State BON website or otherwise look up Nurse Practice Acts in your state.

My line of thinking it that, yes, you can refuse an order if it falls outside of the Nursing Practice and/or does not fit into a system of checks and balances. ie. the doctor writes an order for a med. but you are unsure of what the med is and if the dosage is correct, yet the doctor insists that you administer it right now.

I'm sorry if I'm not being completely clear. When I read your question the very first thing that came to mind was an incident where a nurse in the ER was told by the attending physcian to administer a specific dosage of heparin. The nurse did not know if the dosage was correct, and it didn't appear that the doc. did either. The doc. insisted she administer it and she did, but the dosage was something like 10x's too much and the patient died.

I read about it here on the board. Anyway, don't know if that helps or not, that may be a better example of when if you can "legally" refuse an order.

PJMommy · Sep 17, 2003

I was taught that you can ALWAYS refuse an order if you believe it is unsafe, unethical, or out of your scope of practice. I've seen nurses refuse to give large dosages of some med that the dr. says is an "unlabeled" use. Yes, you get po'd docs but guess what...it's YOUR license on the line.

So yes, my opinion is that it is UNETHICAL to NOT refuse a doctor's order when you are concerned about the patient's or your safety/well being.

renerian, BSN, RN · Sep 17, 2003

I do not have a reference but have many times refused to carry out an order to due mostly unsafe dosing by residents. Yes they are not happy but that is my right and the right thing to do. Some of the dosing were toxic ammounts.

renerian

dgreenbsn · Sep 17, 2003

Thanks for all of your help!

Darrell