Nurses @ Higher Risk 4 Lawsuits. - page 2

I'm hoping to increase nsg awareness on the topic of defensive nursing. Most of you are aware of defensive charting practices. The practice of stating facts--not opinions. However, many nurses... Read More

  1. by   Pretzlgl
    Veerrry scary.

    I feel the way you all described almost daily at work. Therefore, I don't sleep much on the night before a shift. I believe with all my heart that NO ONE will be there if something happens. Nurses truly are the scape goats. It is so sad that the ANA didn't help you TOTALLYBURNED, we all know that the AMA helps docs. Why can't nurses have such a strong voice?

    So, so frustrating.
  2. by   tonchitoRN
    yes, you can say no before you take on an assignment. there will be reprucussions. however, if the other staff does the same you would be amazed how fast they get some help to the floor. they always say "we called everyone and no one could come". that's bs. plus there are not too many lawsuits against the supervisors and head nurses who make these decisions. i'd be willing to bet none of those nurses who have had their licenses pulled were in management. so my feeling they have nothing to lose if they short staff a floor.

    p.s. i know in this litigous society anyone can sue but it seems a prn not given in a timely manner is a frivolous lawsuit and should be tossed.

    p.p.s. totallyburned i emailed you.
  3. by   RNKPCE
    If one refuses to take an assignment and then is fired, do they have recourse for wrongful termination?
  4. by   vivacious1healer
    Quote from batmik
    If one refuses to take an assignment and then is fired, do they have recourse for wrongful termination?

    That's what i want to know!!!!

    I had an assignment a while back in which I had to take 4 patients on a Step-down unit (the usual is 3). Unfortunately the acuity level was high for all 4 patients, which is why I initially refused the assignment. I discussed it with both day/nite shift RNs to change it, (nite shift charge nurse only had 2 patients, and could of taken a 3rd) then paged the HOA and my manager. The HOA listened to my concerns, discussed it with the charge nurses, but eventually sided with the charge nurses that I can handle the assignment.

    The HOA asked me what I planned to do. I replied "well, Im not going to abandon my patients, but it needs to be known that I do not feel safe caring for this # of patients. I paged the manager to see what the alternatives are."
    The manager never called me back. I had to care for 4 patients for 7 hours before I was able to transfer one of them to another floor.

    The following morning I was able to speak to the manager about the situation, and expressed my concerns for patient safety and my licensure. I explained all the steps I went thru to resolve the issue, including asking that the charge nurse take one of the patients (since she can take up to 5 in a nite, and only took 2).

    I was told to go home and think about whether I want to continue to work here.

  5. by   HouTx
    Very interesting thread.

    The OP made a comment that appears to be related to nursing practice in Texas so I was expecting some sort of reference to our "Safe Harbor" mechanism that was implemented by our TX BON several years ago.

    Under Safe Harbor, a nurse who feels that his workload is unsafe can complete a form that documents this situaion. The form is filed with nursing administration & the nurse keeps his own copy.... dated & timed, with details about the situation. IF anything occurs as a result of this situation, the BON is provided with a copy of the document and this becomes part of the deliberative process. In most cases, it is enough to prove that the nurse did everything in his power to remedy the situation, short of simply walking out and abandoning the patients. When done right, it is enough to eliminate any charges of neglect or unprofessional behavior on the part of the nurse.

    In addition, most facilities have a process to aggregate and review all Safe Harbor claims to determine whether the event was unanticipated (one of a kind) or there is a pattern of mismanagement (inadequate staffing, violation of admission criteria, etc). If patterns are identified, they are fixed - at least in my organization.
  6. by   meandragonbrett
    I have zero problems refusing an assignment that I feel is unsafe. If admin wants me to go home I'll go home...No problems.
  7. by   Ruthfarmer
    Refusing unsafe assignments is the only way to go. Unsafe nurse patient ratios with very sick patients is a recipe for disaster. Patient safety must be our priority. Administrators will push things as far as nurses allow them to push. It's up to nurses to take a stand to insure patient safety. I have taken my lumps for refusing unsafe assignments, and I sleep well at night. I did not find that it hindered my job search one bit. I was very up front about leaving a facility over unsafe assignments. There are facilities that do care about appropriate staffing and make it a priority. I don't want to work where appropriate staffing is NOT a priority.
  8. by   dscrn
    Quote from canoehead

    What are the alternatives? He informs the charge nurse that he cannot accept this assignment, then what? There is no one available to take the overflow. So does he wait until they assign him fewer patients, but the most acute? That is even worse. If he says he can take these 8 but not these 4 do they need to agree, or is it his call? (I don't think so) If they say this is it, suck it up, does he go home, leaving everyone, and losing his job? Is there recourse if he is dismissed for insubordination? If he properly goes up the chain of command without results who outside the hospital is prepared, and has authority to make the changes. While he's doing this, and falling further behind what is happening to his patients? (abandonment) If he takes report has he "accepted the assignment" and now is abandoning them. If report is not given how can he say he can't handle the load?

    It takes balls of steel to take a stand against admin, and sometimes your coworkers. We need more information before jumping into this lava pit.
    Your last line says it all....we used to have "unsafe practice" reports that we could fill out, which brought unsafe asignments to mgt. SO many co-workers would just "suck it up", rather than face the heat. ...I once asked the head nurse what it was going to take...was a baby going to haveto die, in order to get the special care nsy properly staffed. She told me that I was being dramatic...
  9. by   dscrn
    Quote from ocankhe
    An interesting thread, I agree with SubQ that we have to take a stand and know when to say no. Then say it. At least in my facility, so far anyway, where RN's have refused unsafe assignments no one had to quit or where disciplined. Low and behold they were able to find a nurse only after the refusal of assignment. We must not forget that many administrators focus and goal is not patient care, its profit and their responsibility to the stock holders is paramount.
    ...and also from mgt "the numbers looked good on paper"(re staffing)
  10. by   TheCommuter
    Although the information being presented remains very relevant and resourceful, please keep in mind that this discussion is over 8 years old.

    Old thread alert.
  11. by   dscrn
    Quote from TheCommuter
    Although the information being presented remains very relevant and resourceful, please keep in mind that this discussion is over 8 years old.

    Old thread alert.
    and more relevant every day, week, month, and year that these conditions are allowed to exist.