Why Nurses Can Refuse Assignments, Essay Example

The practice of nursing continues to evolve in response to demand, resources and the needs of the society which keep on changing. Understanding the responsibilities of the nurse either licensed practical nurse or registered nurse sometimes may pose challenges for the nurses and even their employers. Each nurse is however accountable and responsible for their decisions and practice in accordance with the competencies, educational background of the nurse and the Nurse Practice Act (NPA).

When weighing personal and professional obligations, nurses are counted on to show   accountability and act as leaders while making decisions that best suit the public. They are accountable for giving ethical, safe and effective care to their clients (College of Nursing of Ontario, 2004).its their obligation to act in situations where the care of their client is questionable. They should identify and push for strategies that will help reduce and get solutions in situations in which a client may fail to get essential nursing services. Conflicts however arise between personal and professional obligations forcing nurses to refuse assignment. Nurses should therefore put the aspect of the situation into consideration and be aware of the legislation and standards in order to resolve these conflicts in a way that does not affect rights of the public to safe care.

The Kansas State Nurses Association has a clear guideline on the responsibility that is expected of nurses has sought to provide a clear guideline of the criteria to be used by a nurse in deciding whether to accept or reject an assignment. All these guidelines are set out with a clear understanding that the success of nursing is based on the successful interplay between the various specialties of the care providers to give a wholesome experience to the patient. The state association however recognizes at the same time that there might be conflict of interest between the administrators, the managers, the nurses and the patients. Self interest might come into the picture and this could result in either the patient or the nurse or both suffering (KASNA).

The first reason why a nurse can refuse an assignment is the complexity of the assignment (Martin-miener 2005). Some cases require special skills and qualifications to nurse and attend to. Before a nurse decides on whether to take up an assignment, it is important to access the skills required for the successful handling of the assignment. Some assignments complexities call for cross training or specialist skills that one may not have. On the grounds of these one may opt not to take up an assignment since they will not be able to deliver good quality care to the patient. Since this is the main objective of a nurse, they should strive at all possible opportunities to ensure that the patients health is paramount.

The other reason why a nurse can refuse an assignment is if they are handling a patient who is threatening physical or legal harm on the nurse. This is a matter of serious offensive behavior towards a nurse. The safety of the nurse is paramount and the nurses association pays very particular attention to this issue. There are some patients who become a security threat. This is because the hospitals do not choose who their patient becomes and who does not. If the patient threatens legal action against a nurse, it means that the mutual trust between the nurse and the patient is broken hence the nurse has to notify the authorities of this development and therefore cease caring for the patient.

The nurse can also refuse an assignment where they are required to handle their own relatives. This becomes a major issue because the nurse is expected to ensure they do not get overly emotionally attached to patients to ensure that they retain objectivity in their assessment of the patient as well as ensuring that they give all the patients the appropriate attention to all the patients under their care. By so doing, the nurse will ensure that they retain their ethical integrity and deliver on their expectations. In as much as some decisions might be a thin line of call between the right and the wrong, then the nurses have to make decisions that move towards delivering the appropriate quality of care to the patients.

The other reason is if the nurse’s personal health is being put at risk by the assignment. The hospital should be properly equipped with the necessary protective equipment to ensure that they are well protected. Such facilities like a good incinerator as well as biosafety level cleaning facilities are very vital to ensure that the nurse. Nurses who are exposed continuously to infectious diseases can refuse t take an assignment if the facility they are working in is not fitted with appropriate infection prevention facilities.

Finally a nurse can refuse an assignment if it conflicts with their professional integrity. The nurse is well trained on matters of professional ethos and integrity and is expected   to adhere to the stipulated moral standards to ensure that they do not fall out of with these rules. An example is where a nurse could be required to perform euthanasia.  This conflicts with the professional ethics that require nurses to protect and save lives. Under such circumstances, the nurse can refuse the assignment on the basis of ethics. A nurse might be requested to carry out an act that is contrary with their personal moral or religious beliefs. The nurse might be asked to conceal an act of malpractice which impacted negatively on the patients to safeguard the name of the institution as well as the other practitioners. This bears heavily on the nurse’s conscience and the nurse might decide to turn down the requirement. Another such example is the request to participate in an activity that has serious moral controversies such as an abortion which many nurses will not agree to (Yeo 1996).

Conclusion

Under all prevailing work conditions, nurses the nurses as well as the administrators ought to set out to establish amicable working conditions for them to deliver good quality service to the patients. The relationship should take care of the mutual interests of all the participants as well as the interests of all in delivering quality care to the patients. Similarly under all conditions, it is vital to have adequate communication between themselves and the supervisory management to ensure smooth running of the patient care.

References

College of Nursing of Ontario (2004). Refusing Assignments and discontinuing Nursing services. A practice guideline. Toronto

Martin-miener R. (2005). Journal of advanced nursing. vol. 52,  pp. 231-238. London: Blackwell publishers

Kansas State Nurses Association (KASNA). Guidelines for the Registered Nurse in Accepting or Rejecting a Work Assignment. Retrieved 07 Nov 2009. Available: http://docs.google.com/gview?a=v&q=cache:MjkV2_DB7J0J:www.nursingworld.org/SNAS/KS/AR.pdf+assignments+that+a+nurse+can+refuse+in+kansas&hl=en&gl=ke&sig=AFQjCNGY-Cf8p60UfgRff9WqTmKLm6QTIw.

Yeo M. (1996). Concepts and cases in nursing ethics. New York: Elsevier