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Does an employer have the right to terminate employment based on a nurse’s refusal to accept more patients?

Monday June 25, 2012
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Dear Nancy,

Does an employer have the right to terminate employment based on a nurse’s refusal to accept more patients? The patient ratio on a telemetry unit is 8 to 1. What legal recourse does the nurse have if the employer threatens to report you to the nursing board for abandonment, as there would be no one left to care for that patient?

Marla



Dear Marla,

As discussed in other responses in this column, it is imperative that a nurse not accept an assignment that is truly unsafe and against standards of practice. Keep in mind that the refusal must be an honest one and one that you know poses a risk to the patient(s).

If your facility has a procedure for refusing unsafe assignments (e.g., notifying the nurse manager, documenting same on a form specific for this refusal), you should follow that procedure without fail. It may be, for example, that you can negotiate the assignment by asking that the patient load be reduced to a safe level or, alternatively, ask for another patient care responsibility that does not include the concerns you have with this assignment. Also, remember simply signing out or going home from the workplace without notifying those who need to be notified, pursuant to the procedure will create many legal and ethical problems for you.

Many state nursing boards have defined what abandonment is and how it is a violation of the nurse practice act. Some states have clearly included in the act or rules that refusing an unsafe assignment in and of itself is not abandonment (of course, the details of the refusal would be reviewed). It would be helpful for you to review your act and its rules for some guidance as to this issue in your state.

Should you be reported to the board, retain a nurse attorney or attorney to help you counter the charges of abandonment. This would not be an allegation you should try to defend by yourself.

Sincerely,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.