Is this even Legal?

Nurses General Nursing

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We normally have 3 nurses working per shift but i have a coming up shift where Im the only one on the schedule to work this particular day. I was told that they have tired to get other nurses to come help that day but are not having any luck. its a 16 bed unit. If im the only one who shows up that day not only will i be charge, admit, discharge nurse but ill also have 16 pts to assess and chart on. Is this even Legal? What do I do in a situation such as this?

Specializes in Surgical Specialty Clinic - Ambulatory Care.

Sorry, I do not care how safe harbor is SUPPOSE to work. If you show up and take this assignment....any of this assignment....your hospital will find some way to place blame on you if you show up. Most of us here were new and trying to be helpful once.....new flash: Helpful, decent human beings are the ones that get *** on. You worked to hard for your license to even think about putting it in this much jeopardy. CALL IN!!!!! Management doesn’t get paid nearly enough to deal with bull like this, and it certainly sucks to let them down, however you are the most exposed in this situation. C.Y.A. always. They will have to figure it out without you. I also would start looking for another job ASAP. There are lots, don’t bring up this incident in your next interview; just say that you just didn’t feel like you fit in their work culture well and felt best to exit on good terms.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
On 4/13/2019 at 7:43 PM, Kallie3006 said:

https://nurseguidance.com/when-an-assignment-is-unsafe/

This has some good information in it that could be of benefit to all of us.

Thanks. It was helpful.

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I have no idea if this is legal or not but it is certainly very dangerous, for the patients and for your license. If you show up to work this shift you will be held to exactly the same duty of care, for every single one of those patients as you would if you only had the usual 1/3 of the case load.

I would immediately inform your manager via email with a cc to HR that the proposed assignment is dangerous and that if it is not appropriately staffed by the close of business the day prior you will not be arriving for your shift.

This is obviously laying down a serious gauntlet and may leave you unemployed and ineligible for rehire but it will also make it clear to them that you won’t tolerate letting them make you responsible for their irresponsible staffing. It will also ensure you still have an active unrestricted license without which it will be very hard to secure employment in a decent facility that would never dream of treating its staff and patients like this.

Good luck!

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Thanks everyone for your input.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
2 hours ago, Roda dendron said:

Thanks everyone for your input.

I hope you get back to us and let us know how everything turned out.

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There are many helpful professional responses to OP. But just a thought to those who are saying things like "anyone who takes that assignment is stupid", "you will be an idiot if you show up", and things of this nature.'

How about not insulting someone who might make a decision you don't agree with and, instead, only speak if you can offer some support or advise? We need to support each other in a professional way - JMHO!

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Specializes in School Nurse.

Calling out sick won't "protect your job." If you're unionized, it probably blocks you from forcing the issue as well.

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Specializes in Gerontology, Med surg, Home Health.

What is the setting? 16 on a medsurg floor is absurd. 16 In a SNF is a cakewalk

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
4 hours ago, CapeCodMermaid said:

What is the setting? 16 on a medsurg floor is absurd. 16 In a SNF is a cakewalk

It's apparently psych. I once worked on a 22 bed crisis unit. Night shift was staffed by 1 RN and 1 tech. So it just depends on what other variables are present in this case.

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Specializes in Surgical Specialty Clinic - Ambulatory Care.

I don’t really think the issue should be if the assignment COULD be doable based on the specialty. If the standard of care that has been set by the hospital is 1 to 6...they could reasonably add 1 or 2 to his/her assignment....but not 3 times the average number. BTW...current SNF staffing recommendations by the ANA are 1:5.....not 1:16....so I would say that ‘cake walk’ bit really depends on the SNF you are working at.

If it is a unionized hospital s/he is working for then I would have suggested contacting your union immediately with this issue. But I have never had the privilege of working for a unionized hospital, thus my experience has sharply been defined by the fact that I must protect myself and my license above all else. So if I call in and/or get fired it is much preferable to putting myself in a situation where I’m holding the bag. (I have never been fired by the way.)

My second year as a nurse made this clear when I was ordered to discharge a patient over the weekend by a doctor. I refused the order because I found out the doctor had not reconciled the discharge medications and the patient was newly put on dialysis with no dialysis set up for discharge yet. I got cussed out by the MD and the next thing I know the CNO of that hospital was calling me to let me know I had better comply (even after I told her what was wrong with the discharge) or she would report me for practicing outside of my license .... oh, and I most certainly was going to be fired on Monday. (Needless to say I was VERY distraught and feeling very unsure of myself after that.) Right before shift change that patient coded and would have died had he been at home....though there was no reason he should have coded. A week of silence then I’m at work one day and get awarded a ‘patient safety star’ award for “catching an order error”. No apologies for treating me like scum for doing the right thing from my CNO, no thanks/apology from the doctor who verbally abused me that day....I’m not even sure he got a talking to for the incident, and no verbal acknowledgment of how future incidents like this wouldn’t happen (which was the most important thing that needed to be communicated). This is when I realized that had the patient not coded that night, instead of getting an award for doing the right thing ( which should have been the case we whether the patient coded or not) I would have been fired as promised and reported to the BON for practicing outside my scope. My entire nursing career is filled with stories like this to a varying degree. I do not trust hospital managers or the BON...thus I feel the only acceptable advice to give any nurse is to not put yourself in any position that exposes you to error, because you cannot afford to defend yourself to the BON and the hospital will use you as the scapegoat to lessen their exposure.

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Specializes in Gerontology, Med surg, Home Health.

NO SNF I know has a 1:5 ratio and I’ve worked in 20 different ones. ANA can recommend anything it wants but it’s NOT a regulatory body and a 1:5 ratio in a SNF is never going to happen.

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Specializes in Critical Care; Cardiac; Professional Development.
On ‎4‎/‎11‎/‎2019 at 11:49 PM, Kallie3006 said:

If you live in Texas invoke safe harbor (I don't know if any other states have this). If you go in and there is no one else and you are willing to possibly loose your job leave. Do not take report, do not assume care of 1, 5,10 or all 16 patients because then if you leave it's abandonment. If they threaten to turn you in to the board for abandonment they have no leg to stand on if you did NOT accept the assignment. If they promise to have help by such and such time be prepared to not have anyone they could be saying this to get you to come or stay and you will be responsible for every single patient you have accepted the assignment on. Or call in sick.....

Safe Harbor is good advice, but you cannot invoke it prior to taking report. You have to have had report to call Safe Harbor and even once you have called it, you still must work your shift. Safe Harbor doesn't excuse you from providing care. It provides legal protection for providing care in less than ideal circumstances and requires a response from your facility on how they are dealing with the situation.

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