suspension for refusing patient 9

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i was recently suspended for refusing to take my 9th patient on a med surg floor. the whole shift was suspended? is this legal. policy stated 7-8 patients (administration stated it is flexible) can anyone help me?

when they gave you your suspension papers did you fill out what happen and with whom yhou spoke and what other options they had that could have been taken

patients are not stamped out of a cookie press and if you determine that you can not safely give care to the ones you already have assigned to you and the additional pt..you are putting all of the pts [PLUS YOUR LICENSE]...

administration is not going to get up and say that you were overwhelmed if something gos wrong..i promise you that

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i was recently suspended for refusing to take my 9th patient on a med surg floor. the whole shift was suspended? is this legal. policy stated 7-8 patients (administration stated it is flexible) can anyone help me?

This question has come up in my state (Iowa). I don't think it is different in many other states except New York has some good laws protecting Nurses and so does Minnesota.

You may get fired but you have a legal duty to refuse an assignment you do not believe is safe. You need to do this before you accept report. You need to then let the nursing supervisor know immediately. Document, document, document. If there are acuity numbers document them also. Call your state's nursing association and file a complaint. You may still be fired but your state's nursing association will get on this and go to the legislature (hopefully) to keep it from happening again.

This is why we need unions, people! Most of us work in a 'right to work state' a terrible misnomer that makes us believe we are safe from what should be illegal firings. You can be fired at any time for any reason if you live in a 'right to work' state unless you are in a union or there is a specific law to protect that specific incident (passing these laws is what the ANA attempts to do--and has successfully done so in several states).

Remember this, even if you are threatened with being fired, you still have a legal obligation to provide care to the patients you accept. Just because the employer says you have to take a patient doesn't mean you are immune to any standard of care issues. You have the obligation to refuse unsafe assignments or your license could be in jeopardy.

Good luck. Call your state ANA.

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I got suspened once for not charting for another nurse!!!! Imagine that!!!!

Back when I was on the floor, it was nothing to have 13 pts on a team. It is really a shame they suspended you.

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Specializes in Emergency.

I guess the question is, did you leave the patient without any care or was there someone to take over? I can't imagine that you did but hypothetically, If the patient had been assigned to you and there was no one else to take over then your standards give you no choice but to deal with the patient until someone competent is able to resume care. If you left the patient with no care what-so-ever then feel lucky that you were just suspended and not reported to your professional body.

As I said this is "hypothetically" speaking and I'm sure that you didn't leave the patient without care.

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Specializes in ER.
I can't believe administration would suspend an entire shift over something so ridiculous! Couldn't the patient have stayed in the ED? When confronted with situations such as these if I truly feel that I am not able to care for yet another patient I do what I have to to get by in the situation and then when I get home I type myself a little "memo" about what happened, to whom I spoke, what I said, what the response I got was, etc. This has come in handy many times as people turn around and lie sometimes. I, too, have never heard of any "form" relating to unsafe staffing. If you really want to get gutsy there is always the local paper, or investigative journalists who many be willing to look into these matters. I have done that. They may try but employers cannot fire you for exercising your freedom of speech.

Keeping the patient in the ED is NOT the answer! The ED is probably just as busy as the Med-Surg.

The ED cannot tell EMS to "circle the runway" when they don't have beds. The ED cannot tell Mrs. Smith to have her MI somewhere else. The ED cannot turn anyone away. It's called EMTALA and COBRA!

Chip

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Good for you..and sorry for the flack you got!

I too did this once...but I had 9 patient and about to get TWO MORE!!!!!! I was on a neurovasc floor and these patients were fresh masectomeis! Guess that floor was full! I said I was not experienced in the needs of TWO patients of that kind on top of my 9 patients...and refused to take them (which was so hard for me...flip flopping in my brain about being a good nurse caring for patients that need me, and my limitations on having too many patients..and the pure utter fear of punishment!).

Let's just say that was the day before I left that facility and don't even look at it without discust when I drive by (and that was 3 years ago...I am talking heart felt discust!!!).

From what I understand...you can not be found in the wrong legally for declining the patient load..but if you said yes then change your mind it becomes neglect...someone may clear that up for me if I am wrong... They can fire you most certainly, but you can't get your license hurt by saying "no, that is too much for me and I can't safely handle that patient load".

Good luck to you...and keep that up..encourage others too. Nurses have the tendancy to give an inch, and management takes a mile..that is universal. If we take stands...we can shorten that back to an INCH!

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I work in LTC in FL, and was in the same situation. Our LTC has acite wing, and Pts there complex, they are not long term care, they are more rehab. A lot of amputees, post ops. I worked for them for about 4 months. I realized i can deal safely with 20 pts max. It is just my limit. They are ACUTE, full codes, a lot of times 911 is called. In this facility they admit anybody - stabl or not.Several times (last week 2 days in a row) nurses kept calling in sick. ADON just simply assigned 30 pts to the nurse instead of 20. In this facility they don't step in and work the floor. They just go home. Ok, maybe they might help with 5 pm meds, but, it doesn't really help. I have more meds at 9pm, and, when they pass 5 pm, they often forget to sign off meds. So, you wondering, did this "helper" give 25 units of NPH or not?

Anyway, I just can't handle 30 pts, it is not safe, i PHYSICALLY can not do it. They say, well, state allows 40. I tried to find official info, but failed. And, honestly, maybe state allows 50, i care less, i can not safely do 30. End of story. I talked to DON, let her know i can not do 30 patients. I stopped scheduling myself either. I am per-diem - they need me they would call, and my question is "what is the staffing today"? I made a decision if i came and see

i have 30 (or more) people again, i will walk away. I even stopped punching in,and unless i know the staffing, i don't take report. I realize, they will get pissed and fire me, well, touhg ****. I am not risking my license.

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Specializes in Utilization Management.
Keeping the patient in the ED is NOT the answer! The ED is probably just as busy as the Med-Surg.

The ED cannot tell EMS to "circle the runway" when they don't have beds. The ED cannot tell Mrs. Smith to have her MI somewhere else. The ED cannot turn anyone away. It's called EMTALA and COBRA!

Our local ERs have a "divert" policy that includes "rotation." That is, if several ERs are on "divert," meaning the ER simply can't take any more, the ambulance goes to the next nearest ER. "Rotation" means that if all the local ERs are overwhelmed, each ER takes a turn taking a patient.

Walk-ins are not turned away.

So in a way, that IS a way of "circling the block." And what happens if Mrs. Smith does have her MI in the ambulance? Very bad luck, but at least it's better than having it at home without any first responder treatment.

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Specializes in ER.
Our local ERs have a "divert" policy that includes "rotation." That is, if several ERs are on "divert," meaning the ER simply can't take any more, the ambulance goes to the next nearest ER. "Rotation" means that if all the local ERs are overwhelmed, each ER takes a turn taking a patient.

Walk-ins are not turned away.

So in a way, that IS a way of "circling the block." And what happens if Mrs. Smith does have her MI in the ambulance? Very bad luck, but at least it's better than having it at home without any first responder treatment.

That works if the next closest ER isn't 35 or more miles away! That's our problem - so we can't ever divert.

It's a problem that more and more hospitals face as the number of ERs decreases. It's also a problem that is faced by specialty centers (trauma, stroke, etc.) as you can't divert the specialty patient here.

Chip

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Specializes in Pediatrics, Emergency, Trauma.
Marla and Steph, I beg your pardon but there are no forms to fill out for unsafe staffing. At least on my unit there isn't. Where are they kept on your unit? Does the manager pass them out for you to fill out?

Now I know all about those internet forms you can print "refusal of unsafe staffing, etc." fill them out to your heart's content.

If I ever refuse a patient and get suspended, they can kiss my happy butt goodbye because I'm not filling out any paper work and I'm not coming back.

Fortunately, I work in a place where if I say I can't do it, they listen. But if I'm having an o.k. night and I can, I won't refuse either. It's that mutual respect thing going on.

Check out your incident reports-usually they have a box nex to staffing issues. I helped a nurse fill out an incident report (for a separate incident) during a clincal rotation, and it does have a box about "staffing issues".

Another incident was that the hospital I worked for was that the evening shift was technically left with two and a half nurses (one leaving at 11 pm) for night shift. Most of the nurses were 7a-7p, plus the one who worked for 3-11 shift. Only three nurses were staffed for night shift, and the other one called out. The nursing supervisor stated that he did not have a problem with it...but we all did! Plus most of the nurses could only stay until 11 pm, according to policy-possibly state (PA) standards, which left stil only 2!

After enough wrangling, we have a supplemental staff for the hospital, and there we three nurses for night shift-still unsafe, but a common practice.:uhoh3:

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Specializes in Trauma ICU, MICU/SICU.

Oh, asked and answered... :uhoh3:

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Specializes in Med-Surg.
Check out your incident reports-usually they have a box nex to staffing issues. I helped a nurse fill out an incident report (for a separate incident) during a clincal rotation, and it does have a box about "staffing issues".

I forgot about incident reports! We do not have a space on it for staffing issues, and it isn't a documentation to refuse assignments.

However, we did have to notify risk management of unsafe staffing when our day nurses were routinely being assigned 9 patients by our manager. This was several years ago and it hasn't happened since.

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