Rules for refusing assignment

Nursing Students Technicians

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I have been employed as a pca for 2 years while in nursing school. Recently I was pulled to another floor as a sitter. After 1.5 hours, they wanted to pull me to another location. I refused the second pull and was told that since I didn't accept the assignment I couldn't refuse it and was considered refusing to work. I was then put on administrative leave for "refusing to work". I knew not to accept the assignment because it would be considered abandonment of patients if I accept and then refuse. I understand that I am considered insubordinate for refusing the second pull. This was not a one time occurrence and I feel like there was a better solution than moving me again after establishing rapport with the client. I Lao do not feel that treating employees fairly to just pull an employee all over for their convenience. Obviously I wasn't the only employee that could do the job because someone had to do the job when they told me to leave. I will probably be fired for this but my question is, how much will this affect me as a nurse and the ability to get hired elsewhere?

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Specializes in Emergency Department.

I will say only two things about this situation. One is that you would only have grounds to refuse being pulled to another location if that would actually result in abandoning your current patient. If there's someone else there that can function as a sitter for that patient, then you wouldn't "abandon" your current patient and can then be sent to another floor. Two, you will likely be fired or severely disciplined for refusing to work your duties as assigned. You will not likely be employable with your current employer in the near future, if at all. It may or may not affect future employment with other employers if they are not related to your current (and likely soon to be former) employer. The "hospital" world is pretty small. Someone you work with today very well could end up being a co-worker somewhere else or could be part of a hiring committee or interview panel tomorrow. That personal knowledge of your work habits could help or sink your future employment.

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^What she said.

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You were a 'sitter' which means that that doesn't require that much work, just merely sitting. Then you are moved, which I would take that is taking care of hospital patients cleaning, b/s checks, perhaps. I can see them letting you go as I know the hell of working in other situations. In nursing school I would just keep my shut and go where I am told. No big deal.

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Specializes in Emergency Department.
^What she said.

"He," but thanks!!

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I am a patient care tech, sitting is only one duty of my job. The person they were replacing me with was a unit clerk, not trained in any kind of patient care, she isn't even allowed to take vital signs. This was just to put a "warm body" in the room to sit. For a patient who is confused and uncompliant, you need someone with some type of training in how to deal with and handle the situation. I refused the second pull for multiple reasons, this only being one. Yes, I can be fired for insubordination but I have never had a warning, right up or even been late in 2 years. Second, the hospital policy says I have the right to refuse a second pull. Third, I am not there under the school as a student but an employee, so there is no need to "keep my mouth shut". That has no bearing on my future as a nurse. Which I just finished school. Also, I understand that the nurse world may be small for some areas but we have 4 major hospitals within

a 30 minute radius of me. If I have ruined a future at this particular hospital it will not be a huge blow. In addition, I will only be a pca at this hospital for 3 more weeks if I am not fired, and am not seeking a nursing position to follow at the hospital. I Just wanted an answer to if I can refuse a second pull.

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If your hospital policy truly states you can refuse a second pull, than your actions were consistent with policy. If the policy does not state that, or you misintererpreted it, termination is likely.

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I am a patient care tech, sitting is only one duty of my job. The person they were replacing me with was a unit clerk, not trained in any kind of patient care, she isn't even allowed to take vital signs. This was just to put a "warm body" in the room to sit. For a patient who is confused and uncompliant, you need someone with some type of training in how to deal with and handle the situation. I refused the second pull for multiple reasons, this only being one. Yes, I can be fired for insubordination but I have never had a warning, right up or even been late in 2 years. Second, the hospital policy says I have the right to refuse a second pull. Third, I am not there under the school as a student but an employee, so there is no need to "keep my mouth shut". That has no bearing on my future as a nurse. Which I just finished school. Also, I understand that the nurse world may be small for some areas but we have 4 major hospitals within

a 30 minute radius of me. If I have ruined a future at this particular hospital it will not be a huge blow. In addition, I will only be a pca at this hospital for 3 more weeks if I am not fired, and am not seeking a nursing position to follow at the hospital. I Just wanted an answer to if I can refuse a second pull.

If they had to use the unit clerk, this tells me they needed you for a different position. When I say sitting, what I mean is there is not much to that job, if you were a nurse you don't have 3 other patients on morphine, family members hovering over your back or busted colostomies to change. Some PCA's here barely get up to take vitals. CNA's have 16-17 residents on a regular day. But you are there 3 more weeks, I wouldn't even worry about it. That is what *I* would do, hope everything works out.

If it is hospital policy then I would refer to that if it was an issue.

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If you're going to work inpatient get used to the idea of being floated to far flung areas of the hospital. A few weeks ago I was floated to a sister unit, pulled back after four hours, received a whole new assignment...etc etc. You're right, it's a pain in the rear but it is the reality.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

If hospital policy (or more likely your employment contract) states you can refuse the second pull, go to HR and report that you did that and are now being accused of insubordination.

But undersand that abandonment or safety is not an issue here. As a tech it isn't your responsibility to decide whether the person relieving you was capable of doing the job. You aren't this patient's nurse. The nurse manager or whoever made the decision has that responsibility. It would have been enough for you to give report to the supervisor explaining that the patient was confused and in your opinion, someone with experience needs to have the assignment. Then let the manager make the decision factoring in your info. That's all you need to do. The decision is not yours and you don't have enough info to make it.

You did not stay in your lane. Which made it harder for the manager to do her job.

What you should have stated was "I'm exercising my right to refuse a second pull."

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Wow-this post is kinda shocking to me! Ive been a tech for many many years. There have been times I've been floated to three different areas in a 12 hour shift. I go with the flow. I wouldn't even think of refusing-and unless it is clearly stated that you can refuse I would assume you would get fired. I think you were out of place to make the decision that a unit clerk couldn't sit for the patient. Thats above your head-and up to your charge nurse or nursing manager. Ultimately they are the ones responsible if something were to happen. Our hospital has "safety companions" for sitters, so maybe thats why I see it differently. They have no medical training and are just their to watch the patient and call us if anything needs to be done. Regarding your ability to get hired as a nurse elsewhere. Getting a job as a new grad nurse is not easy (at least in my location-but I assume its pretty universal). Even though there are four hospitals in the area-you have your foot (or had your foot) in the door at your current hospital Even though it may not have been your first choice, to be employed there, it could have been a backup if needed a job. In addition, if you are applying for a job as a nurse elsewhere, with experience as a PCT, I'm sure a recommendation from your current employer would have been very helpful for you.

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I disagree with the some of these posts. I'm not sure if it justified in the op case to refuse the assignment because I don't know the whole story but there are some instances where you have to refuse an assignment especially if its unsafe. I do not employ the do whatever my employer says motto, they have been some nurses who followed that rule and have gotten themselves in trouble with the board of nursing. To the op, please note that is not uncommon to pulled twice in a shift, especially as a pct, before refusing an assignment make sure you can totally justify it.

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