Refused assignment - Under investigation for not passing meds

[Lorie Brown RN, MN, JD]

Hi Lorie

I'm under investigation for not passing all of the 6am meds on a hall that I had refused assignment of. In fact another nurse did the narc count and report. I already had a hall of my own with 30 high acuity patients and I knew anything another 30 patients was beyond my ability to do safely. I called management to let them know and was told to do my best, which is exactly what I did. I just had my meeting regarding the incident and was told by my DON that it was illegal for me to refuse an additional assignment because I felt it was unsafe. As I await final judgement I just want to know, is it illegal to refuse an unsafe assignment and is my license at risk?

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Dear Under Investigation

Depending on your state, it is ... I won't say "illegal," because there is no statute or regulation governing this with the exception of California and it is only under the circumstance where you can refuse an assignment if you are not properly trained. That does not mean leave. There may be other states that have similar statutes of which I am not aware.

However, refusing an assignment is considered to be patient abandonment which could result in you being reported to the Board. If you are given an unsafe assignment, I suggest you put your concerns in writing, date it, sign it and give it your Director of Nursing so that way they are on notice that if there is a problem that your unit is short-staffed and you had voiced concerns to which nothing was done.

Wishing you the best

Lorie

[canoehead, BSN, RN]

In Maine, if you haven't accepted report, you cannot abandon the patient. I specifically asked the Board about working in the ER, and if my relief doesn't show up, I notify my supervisor, I cannot abandon patients I'm already caring for, but I don't have to do intake on anyone that shows up. Even if I am assigned to the ER and they are seeking ER care.

So the OP didn't take report, she notified her supervisor that she wasn't taking report on that group, but she cared for the patients she DID take report on. It might be insubordination, and a fireable offense, but not abandonment. Staffing is the facility's problem.