Nurse allows tech to refuse assignment

[Nurse Beth, MSN]

Dear Nurse Beth,

I work at a nursing home and I was on 300 hall and I work 2:30 to 10:30 and a girl came in and they had her down for 200 hall. She refused to go on 200 hall and wanted to take the hall I was on so the nurses tried sending me to that hall. I refused also because that's not fair for them to do that just because she didn't want to work where she was assigned and I been on 300 hall since 2:30 what's your take?

Dear Refusing Assignment,

A lot of this depends on what time your coworker came in. If you both came in at the same time and they switched your expected assignment, it's disappointing for you, but well within management's rights.

If it was mid-shift, say, your coworker came in at 6:30 and they switched your assignment, it's still within management rights but causes a lot more frustration for you and disruption in patient care. It also causes an extra handoff in care, which can lead to error.

A couple of things to think about- is it possible there were other reasons for changing your coworker's assignment? For example, maybe a patient in the 200 hall complained about her. Maybe a patient in the 200 hall had received chemo within the last 48 hours, and your coworker is trying to get pregnant.

From what you are saying, though, it sounds like your coworker out and out refused the assignment. If your coworker is a strong personality, a nurse making assignments and trying to avoid conflict will try to resolve it quickly by acquiescing to her demand. The nurse could have been desperate for help and afraid the coworker would go home if she didn't get her way.

This is not to excuse the nurse in charge, because it shows a lack of leadership skills. The nurse has a responsibility to delegate responsibly, based on matching the caregiver's skills to the patient's needs. Not the demands of an employee.

Now it comes to you refusing your reassignment. Unfortunately this puts you at risk for insubordination. What are some other things you could have done?

"I've just finished vital signs and passed water on all my patients. Can Judy pass water and take vital signs on all her patients before we switch?" This will point out to the nurse how unfair this is to you.

"I would like to keep the assignment I have. I've already done a lot of work and established a relationship with my patients. Is there a reason this is best for patient care?"

and I am going to include this one for the bold:

"Are you saying it is acceptable for Judy to refuse an assignment? If so, is it acceptable for me to refuse an assignment?"

Good luck, my friend.