Refusing a Clinical assignment

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As students, do we have the right to refuse to participate in any given clinical assignment or proceedure? For example, if you are assigned a patient or order you are not comfortable with can you decline? Being "green" and nervous we all have to put in our chops, I get that, but what if it is an area we are really not ready for? What happens if we refuse?

If you crush an extended release med, then isn't the pt getting the full dose right away?

Yes. So in a situation where this is necessary, you give smaller doses more often.

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As far as I know I can't refuse an assignment unless it is a safety issue for myself or the patient etc. Not sure but wouldn't refusing to treat or take care of someone get you in trouble with breach of duty negligence or patient abandonment? (it did as a medic, but I'm not 100% sure if it's exactly the same for nurses)

Anyway I know there will be days where I want to scream or just plain go home for the day, but if I can't handle the bad days with support as a student I don't think I'll be able to handle them on my own when I'm a nurse. Right now a lot of people in my clinical group are way outside their comfort zone. If you ever find yourself in our situation use the opportunity to extend your comfort zone and ask for help with stuff or look it up and ask someone to oversee you doing it. If you come across something that breaks the rules you were taught like crushing pills etc ask questions and try to figure out the rationale behind stuff like others mentioned above because just flat out saying no typically is accompanied by at the very least the evil eye and at worst a dressing down.

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Specializes in NICU.

True, of course, but many people made it seem like a RN can never refuse an assignment for any reason.

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Specializes in OR.

I have a question on this particular thread. I'm still in school, obviously -- but this thread from the newsletter struck a chord with me. There is one thing I can think of right now that I want nothing to do with and that is a circumcision. I understand declining to care for a patient who is being sexist or is an ex or would otherwise create a potential ethical conflict of interest, but on this, I am absolutely firm. I want nothing to do with a circumcision and if I have to make up a religion to cover it in order to claim religious exemption, I feel inclined to do so. Do we have to be involved in one in clinicals? Mine start in Jan so I'm unfamiliar with what is required in clinicals, as yet.

Mei

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Specializes in LDRP.
I have a question on this particular thread. I'm still in school, obviously -- but this thread from the newsletter struck a chord with me. There is one thing I can think of right now that I want nothing to do with and that is a circumcision. I understand declining to care for a patient who is being sexist or is an ex or would otherwise create a potential ethical conflict of interest, but on this, I am absolutely firm. I want nothing to do with a circumcision and if I have to make up a religion to cover it in order to claim religious exemption, I feel inclined to do so. Do we have to be involved in one in clinicals? Mine start in Jan so I'm unfamiliar with what is required in clinicals, as yet.

Mei

I am anti circ as well, but would never impose my views on a patient.. You will not be performing a circ, a pediatrician will. I was asked to observe one and "assist" by comforting the baby and giving him sugar water during the procedure. I felt bad for the baby, but I didnt refuse the oppurtunity to observe how its done. Honestly, I think if i would have told my teacher I dont really want to be a part of it, I think she would have been okay with it, but it probably depends on your teacher.

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Specializes in Emergency Nursing.
I am anti circ as well, but would never impose my views on a patient.. You will not be performing a circ, a pediatrician will. I was asked to observe one and "assist" by comforting the baby and giving him sugar water during the procedure. I felt bad for the baby, but I didnt refuse the oppurtunity to observe how its done. Honestly, I think if i would have told my teacher I dont really want to be a part of it, I think she would have been okay with it, but it probably depends on your teacher.

OB docs perform circumcisions since they complete surgical training as part of their residency. Pediatricians do not have surgical training as part of their residency and don't perform circumcisions or any other surgical procedure for that matter.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have a question on this particular thread. I'm still in school, obviously -- but this thread from the newsletter struck a chord with me. There is one thing I can think of right now that I want nothing to do with and that is a circumcision. I understand declining to care for a patient who is being sexist or is an ex or would otherwise create a potential ethical conflict of interest, but on this, I am absolutely firm. I want nothing to do with a circumcision and if I have to make up a religion to cover it in order to claim religious exemption, I feel inclined to do so. Do we have to be involved in one in clinicals? Mine start in Jan so I'm unfamiliar with what is required in clinicals, as yet.

Mei

While most of your requests to not participate in procedures will be honored as a nurse, if you are the only nurse available you have an legal obligation to care for your patient regardless of their personal/religious beliefs. You, as the nurse, are to care for the patient and not impose your personal beliefs on your patient.

For example.....my Jewish OB/GYN and Pediatrician did not refuse to care for my son when I chose not to circumcise him. They were professional and provided me with the correct information about potential health risks etc in the future and allowed me to make my own decision while they taught me the care of an uncircumcised member.

As long as it is not illegal....you are obliged to care for your patients regardless of your personal beliefs. Even in abortion, Let's say a patient walks into your ER and has had an incomplete AB performed...if the mother's life is on danger and requires immediate attention and you are the only nurse you are obligated to care for that patients regardless of your personal beliefs.

Odds of that happening? Slim. As a student? your school may have their own policy and point of view.....I would discuss it with your instructor and school instead of making up a religion" for I believe that lying won't be viewed in a positive light. NUrsing is about the care of others....not a platform for personal agenda.

I wish you the best on your nursing journey.:loveya:

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Specializes in Forensic Psych.

OB docs perform circumcisions since they complete surgical training as part of their residency. Pediatricians do not have surgical training as part of their residency and don't perform circumcisions or any other surgical procedure for that matter.

Actually, they do. OBs generally do it on neonates in the hospital, but some pediatricians/family physicians do circumcisions in outpatient settings.

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Specializes in Ortho Med\Surg.

Actually, they do. OBs generally do it on neonates in the hospital, but some pediatricians/family physicians do circumcisions in outpatient settings.

Yep. I chose to have my son circumcised by my OB rather than his pediatrician simply because my OB charged less ;)

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Specializes in PICU, Sedation/Radiology, PACU.
OB docs perform circumcisions since they complete surgical training as part of their residency. Pediatricians do not have surgical training as part of their residency and don't perform circumcisions or any other surgical procedure for that matter.
Not true. All medical residents learn circumcisions as part of their training and MANY children are circumcised in their pediatrician's office, rather than the hospital.
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Specializes in OR.

Do not get me wrong about this "personal agenda" BS. It isn't my personal AGENDA and I will care for anyone who walks in having had an abortion or needing care otherwise. I've been a homebirth midwife for 7 years and I'm no newbie to all the rest as you've described. However, I do not believe in genital mutilation and I would decline to be present for a female child having it done (illegal in the US, not in other countries) as well as a male under the same ethical belief. I'm not inclined to participate in abortion, either, but I would care for someone suffering the after effects of it. These aren't unusual or under any logic a reason I should be chastised for not providing care based on a personal agenda.

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Specializes in Labor and Delivery.
I have a question on this particular thread. I'm still in school, obviously -- but this thread from the newsletter struck a chord with me. There is one thing I can think of right now that I want nothing to do with and that is a circumcision. I understand declining to care for a patient who is being sexist or is an ex or would otherwise create a potential ethical conflict of interest, but on this, I am absolutely firm. I want nothing to do with a circumcision and if I have to make up a religion to cover it in order to claim religious exemption, I feel inclined to do so. Do we have to be involved in one in clinicals? Mine start in Jan so I'm unfamiliar with what is required in clinicals, as yet.

Mei

I had my OB clinical last winter and we were required to see at least 1 lady partsl birth, circumcision, and c-section. So if you feel that strongly about it then you may have to discuss your feelings with your professor ahead of time if they tell you its a requirement. You cant make up religious stuff, hahhaha if so I have a religious expention from any patient that is incontinent or smells

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