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Ebola - My Right to Accept or Refuse an Assignment

Disasters Article   (14,304 Views | 29 Replies | 717 Words)

Julie Reyes has 6 years experience as a DNP, RN and specializes in pediatrics, occupational health.

1 Follower; 44 Articles; 65,824 Profile Views; 260 Posts

Ebola has been the dominant topic on the news for a few weeks now. Nurses have been making the front page, insisting on their rights to be adequately protected from this deadly virus. Nurses everywhere are wondering what their rights and responsibilities are when it comes to accepting or refusing an assignment to care for a patient with a contagious illness, such as Ebola. Do you know what you will do?

Ebola - My Right to Accept or Refuse an Assignment
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Ebola. The very name of this evil virus is striking anxiety in the bravest of nurses. Nurses everywhere are facing the question of "what will I do when it comes here?" We ask ourselves if we would accept the assignment of caring for the patient, or refuse it. We consider the cost of risking our lives to care for the sick - and - what about my children? What about my loved ones? If I accept this assignment, am I putting my family at risk?

I have heard an array of comments on the subject from nurses - and all of their concerns are valid. I have heard more than a handful of nurses' state they would ask for a new assignment - or quit. I have heard the opposite end of the spectrum as well, where nurses will accept the assignment IF. The 'IF' is a pretty big IF.

IF the nurse is properly trained, IF the hospital has the PROPER PPE, IF the nurse will receive hazard pay, IF the nurse will be given a room on the floor with the patient for the next month - because they certainly do not want to take anything home to the family. All very valid requests. If you are given an assignment to care for a patient, but do not have the proper PPE, have not been properly TRAINED in donning and doffing the CDC PPE, or if you have an underlying issue - such as pregnancy or decreased immune system, you may consider Safe Harbor as your reason to refuse the assignment.

So, what are our rights on refusing an assignment? What are our responsibilities to care for a patient? The Nurse Practice Act (NPA) relates to safe practice of nursing through regulations as determined by the Board of Nursing. When a nurse is given a license, the nurse must clearly understand her/his own competencies. If a nurse is not competent to care for a certain type of patient, the nurse then has the responsibility to obtain training/education for assignments in the field where they are working. The nurse must realize that working in an area they are not competent in can put the patient at risk for harm, and the nurse places his/her license on the line. If the nurse has not been properly trained in donning and doffing the APPROPRIATE PPE the CDC recommends in caring for a patient with Ebola, you may have a case to refuse your assignment. If your hospital does not HAVE the proper PPE, equipment, isolation room, etc., to care for your patient in a safe environment, you may have justifiable cause to refuse your assignment.

When is refusing to care for a patient considered abandonment? This is AFTER you have made contact with a patient, or after you have accepted an assignment. For instance, if you are an ED RN and a patient comes in and you begin caring for the patient only to find out the patient has Ebola, and then you refuse to care for the patient any longer - this is abandonment. If you abandon your patient, you can lose your license to practice nursing.

Most hospitals are asking for volunteers to care for any patient who may present with Ebola. A core group is properly trained in PPE donning/doffing. Most hospitals are utilizing ED and ICU RNs for their 'Ebola Task Force'. The hospital I work for also will allow the trained volunteers to live at the hospital in the same unit that has the patient in isolation, and will provide meals and scrubs.

Many nurses I talk to are worried about caring for these types of patients, and I completely understand their concerns. However, I have also found that there are nurses who are ready to face the challenges that are ahead of us and do all they can to care for the patient. I personally believe that caring for any patient with any illness is my responsibility and part of the oath I took when I dedicated my life to caring for people. I know I am not alone when I say I will do whatever it takes to save a life.

Julie Reyes, DNP, RN

1 Follower; 44 Articles; 65,824 Profile Views; 260 Posts

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tnbutterfly - Mary is a BSN, RN and specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

14 Followers; 141 Articles; 5,637 Posts; 203,720 Profile Views

Thank you for this very timely article. This should answer the questions of many nurses regarding their rights when dealing with Ebola patients.

Edited by tnbutterfly

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Saiderap has 25 years experience and specializes in retired from healthcare.

539 Posts; 15,536 Profile Views

"What about my children?" Before Ebola even came I think people had the right to put them first.

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Julie Reyes has 6 years experience as a DNP, RN and specializes in pediatrics, occupational health.

1 Follower; 44 Articles; 260 Posts; 65,824 Profile Views

"What about my children?" Before Ebola even came I think people had the right to put them first.

Absolutely! The article is showing some of the concerns I have heard voiced by nurses I work with. :D

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sirI has 30 years experience as a MSN, APRN, NP and specializes in Education, FP, LNC, Forensics, ED, OB.

16 Followers; 19 Articles; 13,373 Posts; 142,598 Profile Views

Thank you for this Article.

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2 Followers; 14,620 Posts; 106,365 Profile Views

I have to question the description of Ebola as an "evil" virus at the opening of the article. Viruses aren't "evil" any more than houseplants are "evil.". The virus is just doing what it does.

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224 Posts; 6,581 Profile Views

I have to question the description of Ebola as an "evil" virus at the opening of the article. Viruses aren't "evil" any more than houseplants are "evil.". The virus is just doing what it does.
This is your takeaway from this thoughtful article? You have to question the writer's characterization of a deadly virus as "evil?" You cannot fathom the use of this adjective? You must point out to her and her readers that soulless matter is not capable of "evil?"

Thumbtacks may not be "evil," but when one is lodged in my foot, I'll at least momentarily consider it such. And I'll call it even worse.

And the thumbtack isn't liquefying my insides and ushering them outside.

:yawn:

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1 Post; 635 Profile Views

This is a great article! I.will be taking my boards soon..

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Julie Reyes has 6 years experience as a DNP, RN and specializes in pediatrics, occupational health.

1 Follower; 44 Articles; 260 Posts; 65,824 Profile Views

I have to question the description of Ebola as an "evil" virus at the opening of the article. Viruses aren't "evil" any more than houseplants are "evil.". The virus is just doing what it does.

i agree! Again, I am sharing the reaction of how people are reacting to the news. This use of the adjective "evil" sets the stage for how people are perceiving the virus! :)

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xoemmylouox has 13 years experience as a ASN, RN.

1 Follower; 3,150 Posts; 38,964 Profile Views

This article had useful information in it. I am still undecided what I feel my role should be. I have thus far not been trained in ANY way, nor have they told us where the correct PPE is being kept (which leads me to believe we don't have the right items). So as of today I would not knowingly expose myself, and care for a patient with Ebola. I have also told several of my managers that IF I were to be exposed I would be moving in because I'm not taking this home to my family.

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