From the moment we set foot in nursing school, we knew that along with the term “Nurse” are responsibilities that need to be fulfilled dutifully. From that moment, we dedicated our own lives to saving others, helping other people, especially the sick recover back to wellness, and everything that comes with it.
However, there will always be times wherein you do not feel like doing a certain something such as accepting responsibilities way beyond your scope of practice. Is it okay to say no, at times? Or should you just say yes, though it’s against everything you believe in? In what instances can you refuse a nursing assignment? When can you say no?
Assignments outside scope of practice
If you suspect that you are being given an assignment that goes way beyond your scope of practice, clarify it to your superior immediately. As nurses, we can only function and perform tasks within our scope of practice.
The principle that facilities can’t require nurses to perform tasks that are beyond the scope of their licensed responsibilities are upheld in a number of courts so if your employer fights your challenge of the policies or procedures, contact your state board of nursing.
Assignments beyond level of skills
In cases where you get floated or transferred to another unit, let the assigning nurse know if you’re not current on a specific skill needed and if you feel providing certain care would be unsafe. It’s better to lose your pride that to risk your patient’s safety. Those superiors who delegate care to those they know can’t safely provide it become accountable for injury caused to the patient.
Rejecting to accept an assignment after arriving for shift report may lead you to be charged with abandonment if you walk away without placing your patients safely into the care of another qualified staff member.
If you don’t have a written agreement with your employer about staffing expectations, you may have to accept the caseload. It is best that you orient yourself of the facility’s policy on compulsory overtime and distinctive nurse-to-patient ratios. Also, make a mental note of keeping copies as evidence of what you were promised when you were hired. If the employer won’t give you written confirmation, you may not be able to say no to demands that go outside what you were told you could expect.
If you’re busy
When helping a co-worker perform a specific task to another patient, make sure that you do not overlook your own nursing duties. In case of emergency, assess if your patient’s care can safely be deferred for the time needed to help another healthcare team member.
Depending on the state law and facility policy, you are legally allowed to say no to compulsory overtime without career-threatening consequences. There are states legislating laws to ban mandatory overtime, so it is best to check with your state board of nursing or state attorney general to determine your state’s status.
However, if compulsory overtime is legalized under state law and facility policy, it is best that you explain to the nurse manager the reason why you need to refuse working an extra shift. Document your concern with a Protest of Assignment form, if your facility has one. Or if inadequate nurse staffing is a pattern, submit an event report to risk management.