I did some PRN at a facility that expects the noc RN to cover by herself unless it was a particularly unstable pt. They told me that during the interview and said I might cover nights occasionally. I saw a copy of the ASPAN standards book in the room and mentioned that I was certified, was familiar with the standards, and would always practice at or above the minimum standard.
When I covered nights I did call in a backup RN and never heard boo from management. If they had tried to press their point my plan was to do a Midas about being told to work outside of published national standards. A Midas would have been reviewed by risk management and I'm pretty sure they wouldn't want to see something like that documented. It never came to that.
Granted, they could have let me go but they didn't. Also, I was a bit bolder because it was not my primary employment. My main job believes in and works within ASPAN standards. I made sure of that when I interviewed years ago.
Bottom line, if I worked without a backup and there was an incident ( emesis with aspiration, desaturation, code, etc ), the hospital and I could be seen as negligent. It would be a personal injury lawyer's dream. I will not risk my license, my assets, and my livelihood so a hospital can save a few dollars.