refusing assignment

Specialties Agency

Published

Hello all, my question is can you refuse an assignment last minute, at shift change and be charged with patient abandonedment?

Let me give you a scenario.... you recently started at a hospital that has low census and a nurse called in... that leaves you and a cna to cover the floor (medsurg) the ratio is fine there only 4 pts on the floor however... your unfamiliar to the unit, EMR, brand new phone systems (new to staff as well) etc...and have not received training to do admit/transfer/discharge, or charge nurse duties. The DON is aware you are not comfortable working alone yet and has stated "you wont be the only nurse". Also your a breast feeding/pumping and there will no way for you to go pump. Also this is night shift and no one will answer the phone should you need help. There is no house supervisor. It is likely you will get an admit from er..... can you refuse to work if your issue is your uncomfortable in the environment but confident you can care for the pts currently on the floor.... due to inadequate training which could put the pts at risk.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

You can refuse an unsafe assignment. It will usually happen at change of shift. If you are understaffed, are given a patient assignment that is above your level of expertise, you can refuse. And you will have to get report first, otherwise you can not evaluate the complexity of the care the patients assigned to you will require. You admit that 4 patients with you and a CNA and not the problem. Why are you not familiar with the EMR? Did you receive orientation to this facility? Why would you not have time to pump your breasts? The CNA is there, she can watch the lights while you pump, it does not take that long, 15 minutes? You can take 2 breaks to do this. Why are you saying that no one will answer the phone? You make it sound like you are the only nurse in the entire building, but yet there is an ER that might send you a patient? So there are nurses in the ER. Is there only one med-surg floor and your are the only nurse on it? How many beds is this hospital? Did this situation already happen? What state are you in? As an agency nurse, you should be able to function in a variety of settings.

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Its constantly undestaffed there, i got 3 hours of orientation and when i voiced my concerns at that time i was told "that it was just a quick run through, and id continue to be trained" this particular situation has not yet happened however there have been several occasions that the charge nurse has attempted to get help bycalling and texting-no answer, no return calls.ive seen this myself. There are 3 nurses in the ER and theyre not allowed to leave the ER. There is one medsurg unit and yes i would be the only nurse on it. Its a 92 bed hospital In texas. i was told i couldnt pump if i was the only nurse there. I cant take 2 15 min breaks i have to be with a pt or at the station. Thanks in advance for any input :)

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Specializes in SICU, trauma, neuro.

I'd plan on never taking shifts there myself, if they're unwilling to provide relief for breaks. Esp pump breaks. That and lunch breaks, I don't play. You don't need to stress about feeding your baby, or risk getting mastitis just because a hospital is stuck in Victorian times. :mad:

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Specializes in Family practice, emergency.

Your facility is required to allow you a pump break. Texas Mother-Friendly Worksite Program - Breastfeeding Laws

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

Texas has Safe Harbor Provision which sounds like it applies to this situation. I have worked in Texas and I threatened to invoke Safe Harbor one time after I had been there almost 14 hours in the ER. As another ambulance rolled in, I was clocking out and was told I could not leave. The charge nurse had the option to call in the on call RN but did not want to due to the budget/overtime. I picked up the phone and informed house supervisor I was invoking Safe Harbor as I needed to go home, and I had a 45 mile drive home. The on call was called in I I left after telling supervisor. And they have to provide breaks for you, both meal & pump breaks and no not sitting at the nurses station. Red Flags all over this, Call your agency and insist they complete your training & they are aware of situation. I would not go back again.

Texas Board of Nursing - Education - Remediation Education

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Specializes in SICU, trauma, neuro.
Your facility is required to allow you a pump break. Texas Mother-Friendly Worksite Program - Breastfeeding Laws

Oh wow, I Googled "breastfeeding laws in Texas" but didn't find anything about the workplace. I forgot that was federal law now! My state has had pump laws at least since the early 2000s, so never needed to invoke federal law on the issue.

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Thank yall so much my anxiety is sky high about all this... my agency blames the facility for the short orientation saying they wont pay for more. If i go back i will be mentioning the federal law and see if thats helps. They automatically dock 30 min for lunch which if you by yourself you dont get ( bc defined its AWAY from your work area and they wont let you leave ) i dont think im going back at this point i just feel like nothing will be done regardless of laws. Im not under a contract so i can get out fairly easily.... thanks again to all

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I would not go back. Remember there is always Uber.

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Specializes in School Nursing.
Its constantly undestaffed there, i got 3 hours of orientation and when i voiced my concerns at that time i was told "that it was just a quick run through, and id continue to be trained" this particular situation has not yet happened however there have been several occasions that the charge nurse has attempted to get help bycalling and texting-no answer, no return calls.ive seen this myself. There are 3 nurses in the ER and theyre not allowed to leave the ER. There is one medsurg unit and yes i would be the only nurse on it. Its a 92 bed hospital In texas. i was told i couldnt pump if i was the only nurse there. I cant take 2 15 min breaks i have to be with a pt or at the station. Thanks in advance for any input :)

I wouldn't accept any position that wouldn't allow me a break to pump my breasts...

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You can be charged with abandonment if you get report.. then refuse.

Agency nurses are expected to function with minimal training to the unit. That is why they get the big bucks.

Nobody cares that you cant "pump" You are agency... deal with it.

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I have never understood why some nurses are so tough on agency nurses. I mean after all they are helping out the unit because of staffing right? Regardless of how much money they make, they are helping. Regardless of being agency, FT, PT, she is entitled to being trained where things are located on the unit and oriented to some of the basic things. She also deserves and is entitled to breaks and being able to pump too. Sounds like her facility has the same attitude as Been there, done that. I wouldn't go back. Not every facility is going to treat you like that.

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