Refusing patient or assignment

[NightNerd, MSN, RN]

Have you? What were the circumstances? What were the consequences? What, if any, legal or ethical guidelines did you consider when making that decision?

[CalicoKitty, BSN, MSN, RN]

For the most part, I only refuse a patient if I've had bad experiences with that patient/family before. Sometimes that happens. The families may not want you back, but you were accidentally assigned. I've had a few patients that were judgmental about race (sometimes schizophrenic), and find that working with them can be more detrimental to the patient. Overall, I realize that there are "easy" days and "hard" days with nursing. Even when someone tries to make a balanced assignment, your 5 "walkie-talkies" can be on the call bell every 2 minutes or critically ill, or your 5 incontinent patients can be great to work with. On my unit, it is very common to change a patient with someone else. (I can work well with the "demanding/needy" types, so they are easy to "trade" with). I've never refused a whole assignment, usually just a patient. Someone always has the easiest team, and someone the hardest. Everyone's day will come for each.