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appendix3 CikguOnline

Guidelines for the Registered

Nurse in Giving, Accepting,

or Rejecting a Work Assignment*

Registered Nurses, as licensed professionals, share Nursing Care Delivery
the responsibility and accountability along with Only a Registered Nurse (RN) will assess, plan
their employer to ensure that safe, quality nursing and evaluate a patient’s or client’s nursing care
care is provided. The scope of professional nurses’ needs. No nurse shall be required or directed to
accountability involves legal, ethical, and profes- delegate nursing activities to other personnel in
sional guidelines for assuring safe, quality patient a manner inconsistent with the Nurse Practice
care. Legal responsibility for the provisions, dele- Act, the standards of the Joint Commission on
gation and supervision of patient care is specified Accreditation of Health Organizations, the
in the Nurse Practice Act 464.001, and the ANA Standards of Practice or Hospital Policy.
Administrative Rules Chapter 59S.The American Consistent with the preceding sentence, the
Nurses Association (ANA) Code for Nurses with individual RN has the autonomy to delegate (or
Interpretive Statements (1985) guides ethical not delegate) those aspects of nursing care the
conduct and decision making of professional nurse determines appropriate based on the
nurses. The ANA Standards and Scope of patient assessment.
Practice (1997) provides a systematic application When a nurse is floated to a unit or area where
of nursing process for patient care management the nurse receives an assignment that is consid-
across patient care settings. In addition, the ANA ered unsafe to perform independently, the RN has
Restructuring Survival Kit (1996) suggests com- the right and obligation to request and receive a
mon strategies to assist the professional nurse modified assignment, which reflects the RN’s
facing assignment and delegation issues during level of competence.
reassignment and reorganization, temporary or The Florida Nurses Association (FNA), the
permanent. Lastly, the employer requirements for Florida Organization of Nurse Executives
safe, competent staffing are outlined in facility (FONE), and the FNA Labor Employee
policies and guidelines. Relations Commission (LERC) recognize that
Within ethical and legal parameters the nurse changes in the health care delivery system have
exercises informed judgment and uses individual occurred and will continue to occur,while empha-
competence and qualifications as criteria in seek- sizing the common goal to provide safe quality
ing consultation, accepting responsibilities and patient care. The parties also recognize that RNs
delegating nursing activities to others. The nurse’s have a right and responsibility to participate in
decision regarding accepting or making work decisions affecting delivery of nursing care and
assignments is based on the legal, ethical and pro- related terms and conditions of employment. All
fessional obligation to assume responsibility for parties have a mutual interest in developing sys-
nursing judgment and action. tems, which will provide quality care on a cost
The document offers strategies for problem efficient basis without jeopardizing patient out-
solving as the staff nurse, nurse manager, chief comes. Thus, commitment to measuring the
nurse executive and administrator practice within impact of staffing and assignments to patient out-
the complex environment of the health care comes is a shared commitment of all professional
system. nurses irrespective of organizational structure.
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