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262 appendix 3 | Guidelines for the Registered Nurse in Giving, Accepting, or Rejecting a Work Assignment* CikguOnline
Assignment Despite Objection “Supervision” - is the provision of guidance by a
(ADO)/Documentation of Practice qualified nurse and periodic inspection by the nurse
Situation (DOPS) for the accomplishment of a nursing task or activi-
ty, provided the nurse is qualified and legally enti-
Staff nurses today face often untenable assignments
tled to perform such task or activity.The supervisor
that need to be documented as such. Critical, clin-
may be the delegator or a person of equal or greater
ical judgment should be utilized when evaluating
licensure to the delegator.
the appropriateness of an assignment. Refusal to
accept an assignment without appropriate discus- Scenario
sion within the chain of command can be defined
■ Suppose you are asked to care for an unfamil-
as insubordinate behavior. Each Registered Nurse
iar patient population or to go to a unit for
should become familiar with organizational poli-
which you feel unqualified—what do you do?
cies, procedures and documentation regarding
■ Suppose you are approached by your supervisor
refusal to accept an unsafe assignment. ANA has
and asked to work an additional shift. Your
recently adopted a position statement and model
immediate response is that you don’t want to
ADO form available for use by SNA members.
work another shift—what do you do?
(Please contact Florida Nurses Association for
further information.) Such situations are familiar and emphasize the rights
and responsibilities of the RN to make informed
Staffng decisions. Yet all members of the health care team,
In the event a Registered Nurse determines in from staff nurses to administrator, share a joint
his/her professional opinion that he/she has been responsibility to ensure that quality patient care is
given an assignment that does not allow for appro- provided. At times, though, difference in interpreta-
priate patient care, he/she shall notify the tion of legal or ethical principles may lead to conflict.
Supervisor or designee who shall review the con- Guidelines for decision making are offered to
cerns of the nurse. If the nurse’s concerns cannot be assist RNs problem-solve work assignment issues.
resolved by telephone, the Supervisor or designee, Applications of these guidelines are presented in
except in instances of compelling business reasons the form of scenarios, examples of unsafe assign-
that preclude him/her from doing so, will then ments experienced by RNs.
come to the unit within four (4) hours of being Guidelines for Decision Making
contacted by the nurse to assess the staffing. Such
assessment shall be documented with a copy given The complexity of the delivery of nursing care is
to the nurse. Nothing herein shall prohibit a such that only professional nurses with appropriate
Registered Nurse from completing and submitting education and experience can provide nursing care.
a protest of assignment form. Upon employment with a health care facility, the
nurse contracts or enters into an agreement with
Nurse Practice Act, 1994, that facility to provide nursing services in a collab-
Administrative Rules Chapt. 59S, orative practice environment.
14.001 Definitions (4/29/96) It is the Registered Nurse’s Responsibility to:
“Assignments” - are the normal daily functions of ■ provide competent nursing care to the patient
the UAPs based on institutional or agency job ■ exercise informed judgment and use individual
duties which do not involve delegation of nursing competence and qualifications as criteria in
functions or nursing judgment. seeking consultation, accepting responsibilities
“Competency” - is the demonstrated ability to and delegating nursing activities to others
carry out specified tasks or activities with reason- ■ clarify assignments, assess personal capabilities,
able skill and safety that adheres to the prevailing jointly identify options for patient care assign-
standard of practice in the nursing community. ments when he/she does not feel personally
“Delegation”- is the transference to a competent competent or adequately prepared to carry out
individual the authority to perform a selected nurs- a specific function
ing task or activity in a selected situation by a nurse ■ refuse an assignment that he/she does not feel
qualified by licensure and experience to perform prepared to assume after appropriate consulta-
the task or activity. tion with supervisor