Nurse's Right to Accept or Reject An Assignment
The American Nurses Association (ANA) and the Virginia Nurses Association (VNA) believe that nurses should object to any assignment that puts patients or themselves in serious, immediate jeopardy. The professional obligations of the nurse to safeguard clients are grounded in the ethical norms of the profession, the Standards of Clinical Nursing Practice and state nurse practice acts.
In 1987 the ANA developed a position statement on mechanisms to support nurses’ abilities to exercise their right to accept or reject an assignment. Various state nurses associations (SNA’s) developed forms that nurses can use to document their concerns about an assignment. In Virginia, Registered Nurses are expected to adhere to standards of practice and action against their licenses can be taken for failure to do so. Refer to the Virginia Board of Nursing website for regulations and guidance documents which direct nursing practice in the Commonwealth.
In 2001 the National Council of State Boards of Nursing passed a resolution that supported nurses' rights to reject requests to work overtime if they believe they cannot provide safe patient care. Adopted by the NCSBN Delegate Assembly, August 2001.
When a nurse considers objecting to an assignment based on aspects of staffing or other safety concerns, the real likelihood of discipline by employers as a consequence of refusal must be considered. Acceptance of an assignment, however, need not be without question. Nurses should work within the chain of command within their agency to achieve resolution and to ensure that patients receive safe, competent care. However, should a situation place patients or staff at immediate risk or be allowed to continue for a period of time without successful resolution, the use of an “assignment despite objection” form can be useful to document the situation and to formally notify management of the nurse’s objection. A model of an Assignment Despite Objection (ADO) form is available online through the Virginia Nurses Association.
ANA Position Statement, Opposition to Mandatory Overtime, October 17, 2001. Available on ANA website: http://nursingworld.org/readroom/position/workplac/revmot2.htm
Center for American Nurses, Key Issues: Appropriate Staffing website: http://www.nursingworld.org/can/issues/staffing.htm
Conroy, Shelley F. “The Nurse Practice Act and Patient Abandonment”, Virginia Board of Nursing, Nursing Notes, Spring 2001. Available on Board of Nursing website: http://www.dhp.virginia.gov/nursing/default.htm
National Council for the State Boards of Nursing, www.ncsbn.org
Virginia Nurses Association, 7113 Three Chopt Road, Suite 204, Richmond, Va. 23226; Phone 804-282-1808 or 800-868-NURS; Fax 804-282-4916. Website: www.virginianurses.com
VNA Workplace Advocacy Philosophy, June 2003. Available on VNA website: www.virginianurses.com