Rights of Registered Nurses When Considering a Patient Assignment

[smoke over fire]

Working for a Union hospital we always used written objections to track unsafe staffing & provide documentation of the nurses reason for objection. It seems now the ANA is advocating the same be true for all nurses in all settings:

The American Nurses Association (ANA) upholds that registered nurses - based on their professional and ethical responsibilities - have the professional right to accept, reject or object in writing to any patient assignment that puts patients or themselves at serious and immediate risk for harm. Registered nurses have the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm. The professional obligations of the registered nurse to safeguard patients are grounded in the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001b), Nursing: Scope and Standards of Practice (ANA, 2004), and state laws, and rules and regulations governing nursing practice

http://www.nursingworld.org/DocumentVault/CNPE/PositionStatement.aspx

[BBFRN, BSN, PhD]

Those who don't work for union facilities should be able to find an assignment under objection form on their state nurses assn. website.

It is usually suggested that you give 1 copy to the house supervisor, fax 1 copy to the state nurses assn., and keep a copy for yourself.

[CHATSDALE]

is this based on the nurse/patient ratio??

could this be on a patient that you feel you have not had adequate traing to care for...ie a critical burn patient when you have been working in ob/gyn??

what happens to patient at this time?

[Julia RN]

This ANA position is a revison to replace the 1995 statement. While any nurse can file an objection to an assignment, the consequences may be severe without union protection- was true in 1995 and still true today (and acknowledged by ANA).

You can certainly use this process when you lack the education/experience needed for the assignment as well as when you are given too many patients or the acuity is too high for one nurse.

What happens to the pt in the meantime? They stay safe- hopefully a supervisor finds a solution. I've seen managers stay and take assignments, elective procedures canceled, patients diverted- all things you would expect in an emergency.

One of the key points, I believe, is treating this as a patient safety emergency.