Refusing an assignment ?

[ShellyRn1117]

Will someone help me understand if it is ok to refuse an unsafe nursing assignment? In light of my other recent post its clear to me that I should have not accepted the assigned patient load. I initially told my supervisor that it was unsafe and I felt uncomfortable. I was told that I did not have that option that it wouldd be abandonment and I would lose my job and license. Well I have lost my job due to an error I made that day due to the patient care load. Can u really refuse an assignment legally? My state does not have regulated patient care ratios. Thank you.

[kessadawn, BSN, RN]

If you haven't been given report on the patients, it's not abandonment. That being said, your employer can still be a jerk about it.

[classicdame, MSN, EdD]

In Texas we have a safe harbor law. The nurse must report the situation within 24 hours and follow the facility's chain of command regarding refusal of assignment. If you are still required to take the assignment and a mistake is made then you keep your license. They cannot force your employer to keep you, however. The BON will follow-up with the hospital and most do not want that kind of attention. None of this has anything to do with ratios. ONE patient can be more than you are comfortable with depending on the situation.

[RNforLongTime]

I know in the state of PA where I work, you are not responsible for patient care UNTIL you have taken report on the patients. My employer tries to say that once you are punched in then you are responsible for caring for patients and they are WRONG!!!

[ShellyRn1117]

That is what my facility says...once you have punched in.. sadly if u do refuse a group then there are even fewer nurses providing care and ultimately the patients pay for this with substandart care. How very sad. All I want to do is take care of my patients safely. Instead daily I have to focus on keeping a job and my license...what has nursing come to? Dollars and cents?

[gentlegiver, ASN, LPN, RN]

In MA. (in LTC) you are not responsible for patients until you both take report and accept the Narc. Box. If you refuse an unsafe assignment then who ever is on-call must find someone to take it or take it themselves. So of course they are going to try to do or say anything thay can to make you take it. They don't want to take it, it's unsafe! Abandonment is when you walk out AFTER accepting an assignment. And yes Nursing has basically become a CYA profession. You do the best you can for your patients but the bottom line is your ability to document everything that happens and protect yourself. Sad really.

[elkpark]

Employers love to throw around the word "abandonment" to intimidate nurses. We've had people post here that they've been told by their employers that calling in sick or resigning without sufficient notice constitutes abandonment!

Contact your state BON and ask them what their definition of "abandonment" is. I worked at one place many years ago where the nurses on my unit were in contact with the BON, seeking advice and guidance about what we could/should do about what we considered dangerous staffing situations, and the BON was v. helpful.

In general, you're not responsible for a group of clients until you have accepted responsibility for them, which typically means taking report on them, not walking in the door of the building and clocking in. The responsibility ultimately lies with the individual RN to decide whether you can safely take on a particular assignment or not -- however, if you do accept the assignment, you are responsible for providing safe, competent care to those individuals, and, if something goes wrong, "we were understaffed" is not an acceptable excuse or defense.

The "catch 22" is that, if you refuse an assignment because it's unsafe, you're protecting your license but you can pretty much assume you're going to get fired by your employer. It's not a good situation in which to be. A few states (like TX, as noted above) have started passing laws which protect nurses in these circumstances, but most states don't have any protection and the individual nurse just has to make the best decision s/he can -- about whether or not to accept an assignment on a particular day/shift, and about whether you want to continue working for an employer if you are repeatedly put in that situation.

[Whispera, MSN, RN]

Elkpark is so right about the catch 22. Yes, you can refuse an unsafe assignment legally. Yes you'll probably be fired anyway. Then, yes, you can sue, if you can afford the lawyer, and it will be expensive...

People are often telling others here to get a lawyer. That's all well and good, but it's extremely expensive, and even if you're employed, still potentially un-affordable. Then cases can drag on for years, with the one doing the suing having (possibly) no income while a decision is reached. Meanwhile the legal fees continue to rise.

[nurse2033, MSN, RN]

I agree that until you have taken report you cannot be responsible for patient care. If you feel your assignment is undoable you can refuse it. You might lose your job but better than your license.

[Batman25]

Maplractice insurance for nurses really isn't all that expensive. Check into www.nso.com ASAP and pls get yourself some. I pay about a $100 a year and it's worth every penny. This is a prime example of when it will come in handy.

Your employer is lying. Punching in and leaving doesn't equate patient abandonment. They say that to trap and scare you. It's wrong. If the assignment is unsafe we say it. Turn it down. They can't force you to take it and if you truly think it puts patients and your license at risk NEVER accept it. You will have a hard time if sued because you would have taken it knowing you couldn't provide safe care. Look out for yourself and your patients. I'd prefer to lose my job then my license and more importantly harm a patient.

[Whispera, MSN, RN]

Malpractice insurance doesn't apply if you refuse an assignment. It only applies if you do something wrong in the care of your patients, or are accused of doing something wrong.