Safe Harbor/ Working Under Protest

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I re-posted this because I desperately need help with this "Safe Harbor" thing. What is it? Does it involve the BON or JCAHO? How is it done and what sort of protection does it afford you? I have also heard of "working under protest"; you accept the assignment but sign a form or put it in writing that you believe that you are working under unsafe conditions due to pt. overload/ high acuities. Again, how do you go about doing this, who do you submit it to besides mgmt. (and I'd assume keeping a copy for yourself) what protection does it give,etc. I have heard of an "Assignment Protest Form", if anyone knows of one or it's equivalent, please let me know. If I had some idea of what the wording should cover from a legal standpoint it would help. If anyone out there has any info on this they are willing to share on any of this I'd be very grateful. There have been a few times after report or as I was getting report that I was in over my head (the last time was when the other nurse was a no-call, no-show and we usually have three!) Supervisor said "hey, we couldn't find anyone- we were lucky to get this nurse!" Who, the one who wasn't there? Any info I can get will be deeply appreciated. Thanks much- melissa

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Specializes in ICU, ER, HH, NICU, now FNP.

Safe Harbor is a Texas thing as far as I know. That doesn't mean that other states don't have it, although they may call it something else. I would call your states BON and ask them the same questions you posted - they will be able to provide you with the most accurate and up to date resources for what you need.

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Specializes in Critical Care.

Before I take 20 min and explain the details of Texas' Safe Harbor program, let me ask you: are you in Texas?

I can explain how to do it in Texas, but I don't know the legal process in other states.

~faith,

Timothy.

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No, New Jersey. I guess I'll have to look up our BON and see if there is something similar. Thank you for your reply, though (and to gauge14iv,as well).Cheers!

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New Jersey has the Conscientious Employee Protection Act. Not sure how many times it has been tested in court. If you work in a Unionized facility the union usually provides either assignment despite objection or unsafe staffing type forms.

The first thing you need to do is in a calm and professional manner approach your immediate supervisor (if a staff nurse is in charge, call the nursing supervisor). Inform that person that you feel your patient's safety is in jeapordy because (too many sick patients assigned together, etc.) Document who you told, when and what their response was or what action was taken. Definetly keep a copy for yourself.

There are pitfalls to speaking up about unsafe assignments even in unionized facilities. The CEPA rules mandate that you conduct yourself in a professional manner and follow the chain of command. For example, you can't complian to just colleagues about unsafe assignments and then write aletter to the editor of a newspaper about the unsafe conditions. You need to first inform your immediate supervisor/manager and if nothing is done after x number of unsafe incidents, then inform that manager that you are going to have to go over their head. Then start at the next level.

More and more, I believe if you work in an unsafe unit where you don't have managerial or administrative support to correct the unsafe situation, you should bail. We live in a profit driven society and health care falls under that. It is very hard to find a facility that doesn't have a profits before patients mentality.

Good luck!

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Specializes in OB, NP, Nurse Educator.

Does your Director of Nursing have a nursing license? One day when I was left alone due to call ins with 23 patients, and two CNA's to help me I called her office and asked her why she couldn't come help me. She told me that she did not know what I was talking about. I explained the situation, told her that the night supervisor told me that EVERYONE had been called and nobody would come help me. She came to the floor, and assessed the situation. It was amazing! She found all kinds of "extra" staff to help me (1 RN, 1 LPN, and 2 more CNA's). She did the 4 discharges and assessed two surgery patients, plus passed meds until noon. The night shift supervisor was reprimanded for leaving the floor in an unsafe sitaution. I would have told our unit manager but she was gone on vacation. Do not assume that administration knows what is going on - supervisors and managers in my experience tell administration what they want to hear.

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Our Administrator, DON and Supervisor are made aware of the situation (in fact, they demand to be) when it occurs and are very responsive, finding staff and calling in unit mgrs. (I work nights) to pass meds if necessary. All are RNs. It is the rare situation when we are very short-staffed and staff simply cannot be found and I feel I need to say or do something to protect myself until admin. can make it in the door or cobble a staff together. I don't freak out or get bent out of shape; I let them know what's going on and get out on the floor ASAP. It's just that you know that's when pts. are more likely to fall or go bad or code on you and I can just picture myself sitting in court a few years down the road because some family has sued. We are not union, by the way. Thanks for the info. to all.

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