Negligence with nurses floating-Legal and Ethical Issues | Nurse Key

Oct 29, Magazine , Nursing Careers. They advocate on behalf of patients, their families, the community, and society as a whole. Nurses face the same legal issues as many other employees, such as sexual harassment in the workplace. But they also must protect against career-specific liabilities, such as being accused of violating the nurse practice act or similar regulations. The first concern is nurse-to-patient ratio, two is violence in workplace, and three is scope of practice.

Negligence with nurses floating

Negligence with nurses floating

Negligence with nurses floating

Delegation, used throughout all of nursing history, has evolved into a complex, work-enhancing strategy that has the potential for varying levels of legal liability. I was Strapon girl fuck boyfriend that my BSN degree and current RN license satisfied the training requirement for clinical nursing. Having additional critical care training, including the care of pediatric and neonatal patients, is a feather in a nurse's cap if nutses when he or she is looking for employment elsewhere. Therefore, a nurse should likely not proceed to take an evidentiary test of a persons blood if he expresses a desire to have an Damzle riding gear procedure. These six elements are shown in Table Significantly, courts have upheld the firing of a nurse who refused to float to a unit with which he was unfamiliar when he refused the hospitals offer to orient him to that unit and any other units in which he could be asked to float. This evidence-based article explored ways to ensure that all disciplines Nfgligence knowledgeable about Negligence with nurses floating role of collaboration and how such collaboration could be successfully incorporated into a comprehensive cancer center. Known as vicarious liability, or substituted liability, the doctrine of respondeat superior let the master answer makes employers accountable for the negligence of their employees. Many years ago it was considered a serious Negligence with nurses floating of hospital policy for a nurse to question or challenge Negligence with nurses floating physicians instructions.

Asian enemas picture gallery. Chapter 6 Nursing Responsibility and the Law

I would like to suggest a new float policy that would include only floating to units. In unity there is strength! Your message floatjng been successfully sent to your colleague. Get started with Ausmed to document your CPD online. Unit charge nurses and nurse managers can use feedback to improve future float nurses' experiences in their unit. However, the way management is treating the staff, all they are going to do is drive Negligence with nurses floating lot of nurses out the front door to agencies or other areas of nursing ie home health. Staffing patterns of Negligence with nurses floating unit staff nurses vs. NYSNA position statement. No Thanks Get Started with Ausmed. When we document floaying and thoroughly, we provide a written record of care that may protect us should we ever find ourselves facing a charge of negligence. Hendren R. When I risked following the link on Rustrak strip recorder invitation, it took me to a conference agenda, not a agenda.

The unique role that a nurse plays in the health delivery system often puts her in what seems to be a no-win position.

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This chapter highlights and explains key legal and ethical issues as they pertain to managing and leading. Nurse practice acts, negligence and malpractice, informed consent, types of liability, selected federal and state employment laws, ethical principles, and related concepts are discussed. This chapter provides specific guidelines for preventing legal liability and guides the reader in applying ethical decision-making models in everyday clinical practice settings.

Schiavo case as the framework for this analysis. I am the new acting clinical nurse manager on a busy bed acute-care medicine unit in a major metropolitan hospital acknowledges that retaining competent, qualified, and satisfied nursing staff members presents a continual challenge.

The USL was concerned because this nurse has been on the unit for nearly 2 years, seemingly a sufficient time to develop appropriate organizational and physical assessment skills, and asked whether the nurse could need additional education, further orientation, or perhaps a transfer to a less-demanding unit. Although this practice sounded all too familiar, I quickly recognized the ethical and legal implications inherent in such a clinical practice.

The role of professional nursing continues to expand and incorporate increasingly higher levels of expertise, specialization, autonomy, and accountability from both a legal and ethical perspective.

This expansion has forced new concerns for nurse managers and nurse leaders and a heightened awareness of the interaction of legal and ethical principles. Areas of concern include professional nursing practice, legal issues, ethical principles, labor-management interactions, and employment.

Each of these areas is individually addressed in this chapter. The scope of nursing practice, those actions and duties that are allowable by a profession, is defined and guided individually by each state in the nurse practice act.

Nurse practice acts define three categories of nurses: licensed practical or vocational nurses LPNs and LVNs, respectively ; licensed registered nurses RNs ; and advanced practice nurses. The nurse practice act must be read to ascertain what actions are allowable for the three categories of nurses. In these states, the acts must be reviewed at the same time to ensure that all allowable actions are included in one of the two acts and that no overlap exists between the acts.

In addition, nurse managers should understand that individual state nurse practice acts are not consistent in defining or delineating advanced nursing roles.

Each practice act also establishes a state board of nursing. The main purposes of state boards of nursing are, first, to ensure enforcement of the act, serving to regulate those who come under its provisions and prevent those not addressed within the act from practicing nursing and, second, to protect the public, ensuring that those who present themselves as nurses are licensed to practice within the state.

These various boards of nursing develop and implement rules and regulations regarding the discipline of nursing and must be read in conjunction with the nurse practice act. This mandates that nurses and their nurse managers periodically review both the state act and the board of nursing rules and regulations. This is especially true in the areas of diagnosis and treatment; states vary greatly on whether nurses can diagnose and treat or merely assess and evaluate.

An acceptable action in one state may be the practice of medicine in a bordering state. Multistate licensure permits an RN to be licensed in one state and to legally practice in states belonging to the compact without obtaining additional state licenses.

For the purposes of the law, the state nurse practice act that regulates the practice of the RN is the state in which the patient or client resides, not the state in which the nurse holds his or her license.

Many of the nurses practicing under multistate licensure are working with patients in a variety of states through telenursing, which involves the use of telecommunications technology, such as telephone triage and advice. Others work for agencies or clinics that serve patients across state borders. All nurses must know applicable state law and use the nurse practice act for guidance and appropriate action.

Nurse managers have this same basic responsibility to apply legal principles in their practice. However, they are also responsible for monitoring the practice of employees under their supervision and for ensuring that personnel maintain current and valid licensure. Unless nurse managers remain current with the nurse practice act in their state or with nurse practice acts in all states in which they supervise employees, there is the constant potential for liability.

How does your state address advanced practice? Describe why it is vital that the nurse manager understands these distinctions. Nurse managers frequently serve as mentors and consultants for the nurses whom they supervise. It is imperative that nurse managers have a full appreciation for this area of the law as negligence and malpractice continue to be the major causes of action brought against nursing staff members.

Managers cannot guide and counsel their employees unless the managers are fully knowledgeable about this area of the law. Negligence denotes conduct that is lacking in care and typically concerns nonprofessionals. Many experts equate negligence with carelessness, a deviation from the standard of care that a reasonable person would deliver. Malpractice, sometimes referred to as professional negligence, concerns professional actions and is the failure of a person with professional education and skills to act in a reasonable and prudent manner.

Issues of malpractice have become increasingly important to the nurse as the authority, accountability, and autonomy of nurses have increased. The same types of actions may be the basis for either negligence or malpractice; Pender v.

Natchitoches Parish Hospital specifically noted that for malpractice there must be a dereliction of a professional skill. Usually, six elements must be presented in a successful malpractice suit. All of these factors must be shown before the court will find liability against the nurse or institution.

These six elements are shown in Table Negligence and malpractice have two commonalities. Both concern actions that are a result of omission the failure to do something that the reasonable, prudent person or nurse would have done and commission acting in a way that causes injury to the patient.

The first element is duty owed the patient, which involves both the existence of the duty and the nature of the duty. That a nurse owes a duty of care to a patient is seldom hard to establish. Often, this is established merely by showing the valid employment of the nurse within the institution. Several sources may be used to determine the applicable standard of care.

The American Nurses Association ANA , as well as a cadre of specialty organizations, publishes standards for nursing practice. The overall framework of these standards is the nursing process. In , the ANA first published Standards for Nurse Administrators American Nurses Association [ANA], , a series of nine standards incorporating responsibilities of nurse administrators across all practice settings.

Accreditation standards, especially those published yearly by The Joint Commission TJC , also assist in establishing the acceptable standard of care for healthcare facilities. In addition, many states have healthcare standards that affect individual institutions and their employees. Nurse managers are directly responsible for ensuring that standards of care, as written in the hospital policy and procedure manuals, are current and that all nursing staff follow these standards of care. Should a standard of care be revised or changed, nurse managers must ensure that all staff members who are expected to implement this altered standard are apprised of the revised standard.

If the new standard entails new skills, staff members must be educated about this revision before they implement the new standard. The second element required in a malpractice case is breach of the duty of care owed the patient. Once the standard of care is established, the breach or falling below the standard of care is relatively easy to show. The injured party will attempt to show that the acceptable standard of care is at a much higher level than that shown by the defendant hospital and staff.

Expert witnesses give testimony in court to determine the applicable and acceptable standard of care on a case-by-case basis, assisting the judge and jury in understanding nursing standards of care. A case example, Sabol v. Richmond Heights General Hospital , shows this distinction. A patient was admitted to a general acute care hospital for treatment after attempting to commit suicide by drug overdose. While in the acute care facility, the patient became increasingly paranoid and delusional.

A nurse sat with the patient and tried to calm him. The patient jumped out of bed, knocked down the nurse who was in his room, fought his way past two nurses in the hallway, ran off the unit, and jumped from a third-story window, fracturing his arm and sustaining other relatively minor injuries.

Expert witnesses for the patient introduced standards of care pertinent to psychiatric patients, specifically those hospitalized in psychiatric facilities or in acute care hospitals with separate psychiatric units. They did not have nor were they expected to have specialized psychiatric nursing training and would not be judged as though they did.

The nurse must have prior knowledge or information that failure to meet a standard of care may result in harm. The challenge is to show what was foreseeable given the facts of the case at the time of the occurrence, not when the case finally comes to court. For example, in Christus Spohn v. De La Fuente , a patient in labor ruptured her uterus when nursing staff failed to appreciate the fact that Pitocin can cause uterine hyperstimulation and the nurses failed to monitor the patient, induced for a vaginal delivery after a prior cesarean section, for such hyperstimulation.

Note that it is not sufficient that the standard of care has been breached but, rather, that the breach of the standard of care must be the direct cause-and-effect factor for the injury. State of New York concerned a patient who sustained an accident in which two fingers were severed while using a power saw. The patient permanently lost the two fingers when the nursing staff failed to follow the order for an immediate orthopedist consultation. The resultant injury, the fifth malpractice element, must be physical, not merely psychological or transient.

In other words, some physical harm must be incurred by the patient before malpractice will be found against the healthcare provider. Although there are some specific exceptions to the requirement that a physical injury must result, they are extremely limited and usually involve specific relationships, such as the parent-child relationship. Pain and suffering are allowed when they accompany actual physical injuries. The injured party must be able to prove damages, the sixth element of malpractice.

Damages are vital because malpractice is nonintentional. A nurse manager must know the applicable standards of care and ensure that all employees of the institution meet or exceed them. The standards must be reviewed periodically to ensure that the staff members remain current and attuned to advances in technology and newer ways of performing skills.

If standards of care appear outdated or absent, the appropriate committee within the institution should be notified so that timely revisions can be made. Finally, the nurse manager must ensure that all employees meet the standards of care. This may be done by 1 performing or reviewing all performance evaluations for evidence that standards of care are met, 2 reviewing randomly selected patient charts for standards of care documentation, and 3 inquiring of employees what constitutes standards of care and appropriate references for standards of care within the institution.

Read a policy and procedure manual at a community nursing setting with which you are familiar. Are any policies outdated? Find out who is in charge of revising and writing policies and procedures for the agency.

Take an outdated policy and revise it, or think of an issue that you determine should be included in the policy and procedure manual and write such a policy. Does your rewritten or new policy define standards of care? Where would you find criteria for ensuring that your policies and procedures fit a national standard?

As the nurse manager within the healthcare setting, how would you go about ensuring that staff members whom you supervise follow the standards of care as outlined in the policy and procedure manual? Even if others can be shown to be liable for a patient injury, each individual retains personal accountability for his or her actions.

The law, though, sometimes allows other parties to be liable for certain causes of negligence. Known as vicarious liability, or substituted liability, the doctrine of respondeat superior let the master answer makes employers accountable for the negligence of their employees. The rationale underlying the doctrine is that the employee would not have been in a position to have caused the wrongdoing unless hired by the employer, and the injured party would be allowed to suffer a double wrong if the employee was unable to pay damages for the wrongdoings.

This site complies with the HONcode standard for trustworthy health information: Verify here. I recieved 4 hours of orientation during which I had a patient load and have been floated all over the hospital. What to do in unsafe patient care situations. Preparing a tip sheet for float nurses with unit-specific information is also helpful. Subscribe Register Login. Document CPD. She stated that she was uncomfortable with this, and was told if she did'nt float it would be grounds for termination.

Negligence with nurses floating

Negligence with nurses floating

Negligence with nurses floating

Negligence with nurses floating

Negligence with nurses floating

Negligence with nurses floating. Article Tools

When I risked following the link on this invitation, it took me to a conference agenda, not a agenda. This conference was to be held in New York about 6 days from the time of this writing. No mention was made of continuing-education credit, but the conference website looked deceptively similar to ours. If you accept a speaking invitation from a predatory group, be prepared to foot your own travel expenses entirely.

You may arrive to find a poorly organized conference, if one exists at all. Other speakers may not show up. If you're a conference attendee who paid a steep registration fee and expected a high-quality program, you may find that conference falls short on content and lacks continuing-education credit recognized by any legitimate nursing organization.

The organizer might also be juggling multiple conferences at the same time in the same venue for unsuspecting nonnursing groups with similar outcomes. Make sure you verify the legitimacy of any educational program before you sign up to attend or speak. That warning extends to accepting invitations to serve on planning committees, sometimes in name only, for these groups.

Read between the lines—don't become a victim of scam conferences and deceptive marketing! You may be trying to access this site from a secured browser on the server.

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Subscribe to eTOC. Advanced Search. Toggle navigation. Subscribe Register Login. Your Name: optional. Your Email:. Colleague's Email:. Separate multiple e-mails with a ;. Thought you might appreciate this item s I saw at Nursing Protest of Assignment forms are also used when the nurse has been given an assignment that is beyond the legal scope of nursing practice under the NYS Nurse Practice Act.

For any single situation, multiple forms may be completed if there are multiple nurses who feel care is compromised. In order to facilitate safe, quality patient care by RNs who are adequately trained and competent to care for an assigned group of patients, and to ensure that the rights of RNs are upheld within their legal scope and standards of practice, the New York State Nurses Association recommends that:.

American Nurses Association. Silver Spring, MD: Author. Gardner, S. Your practice and the law. Holding nurses accountable. Gobis, L. Workplace rights. The perils of floating. American Journal of Nursing, 9 , Higginbotham, E. Advice of counsel.

When you believe an assignment exceeds your expertise. RN, 65 6 , 72, Iowa Board of Nursing. Iowa Board of Nursing position statement: nurses floating to other health care areas. Des Moines, IA: Author. Joint Commission on Accreditation of Healthcare Organizations.

Systems analysis. Ensure that your float staff and contracted staff are providing safe care. Joint Commission Perspectives on Patient Safety, 4 7 , Kany, K. Policy vs. American Journal of Nursing, 5 , Mustard, L. The paradigm shift in RN staffing in hospitals: corporate responsibility and institutional liability.

POSITION STATEMENT ON FLOATING | New York State Nurses Association

The unique role that a nurse plays in the health delivery system often puts her in what seems to be a no-win position. For instance, what should a nurse do when ordered to perform a task for which she does not feel qualified? Should she refuse and face possible workplace discipline, or should she attempt the task and face possible liability? Even when a nurse is superbly qualified to perform a task, however, sometimes issues of conscience may prevent her from fully performing the task.

Again, failure to perform may sometimes mean discipline, but for many nurses, adverse employment actions are preferable to carrying out a task that is morally objectionable. This chapter tries to find some middle ground through which a nurse can avoid both legal liability and adverse employment consequences while maintaining her personal ethical standards.

A nurse who performs a task for which she is unqualified faces potentially devastating consequences, both professionally and financially.

In Nevada, the law specifically requires that nurses be competent in their duties. NAC In fact, nursing regulations mandate that nurses ensure that they are competent to execute a task before attempting it. For example, a licensed practical nurse must determine before the performance of any task that [s]he has the knowledge, skill and experience to perform the task competently.

A nurse therefore has an affirmative duty to refuse an assignment if she is unqualified to perform it. No nurse can be forced to perform a task she is not qualified to perform. However, the pressures of a workplace often force a nurse to accept and attempt an assignment for which she is unqualified. Unfortunately, the realities of nursing work sometime make it difficult or impossible for a nurse to refuse an assignment without risking being labeled as someone who is not part of the team or a malingerer.

Perhaps the best way to avoid this problem is with open communication with your supervisor, assuming that it is not an emergency situation. In an emergency situation, as long as a nurse can perform at the minimum level required by the law, that of a reasonably prudent nurse in similar circumstances, a nurse should not refuse an assignment. The ANA states that nurses should reject any assignment that puts patients or themselves in serious immediate jeopardy.

The ANA supports a nurses decision to reject an assignment in these situations, even when a nurse is not afforded specific legal or contractual protection for rejecting the assignment.

In addition, nurses who belong to a union often have the terms of staffing, patient care assignments, and procedures for refusing an assignment spelled out in their union or employment contract.

By openly communicating her reservations about accepting a task for which she may not be qualified, a nurse reduces, but does not fully eliminate, the possibility of personal liability.

In addition, when voicing a concern about an assignment, the nurse may offer to instead perform a substitute task for which she is qualified, or offer to assist in the assigned task in any way that she can safely do so, thus limiting negative work-place repercussions.

For instance, a new OR nurse asked to scrub at an unfamiliar procedure without adequate time to research the tasks involved can request nurse supervision at the procedure, if practical, or can offer to scrub for another surgery. As always, the interests of the patient should take precedence over any other considerations when making a decision whether to refuse an assignment. If you are asked to work in an area in which you are unfamiliar, particularly if the area is short-staffed, ask yourself whether the patient or patients would be better served by having no nurse present, or a nurse who is perhaps only minimally qualified to carry out the necessary tasks.

In many cases patients would be best served with even a minimally qualified nurse, assuming that proper supervision and assistance can also be provided. In addition to incurring legal liability, a nurse can be professionally disciplined for performing a task for which she is unqualified.

In Nevada, the State Board of Nursing considers it unprofessional conduct for a nurse to assume duties and responsibilities within the practice of nursing without adequate training. A nurse must also not assume a duty unless she is competent in that duty. Performing a procedure without adequate competence and training may lead to professional discipline, including the loss of the nurses license.

As briefly discussed above, when faced with a situation where you are asked to discharge a task for which you feel unqualified, always state your reservations to the person assigning you the task. Then consider your alternatives. It may be possible to carry out an unfamiliar task if you receive adequate supervision or assistance. Ask whether the assignment could be delayed until you are able to be properly trained on the task.

Obviously in an urgent or emergency situation you will not have time to be cross-trained or to adequately research the intricacies of an unfamiliar procedure. However, in other situations, your willingness to get properly trained on the task will greatly ease any potential friction your refusal will generate. If you continue to feel additional pressure from your employer, check your employee manual and the Nevada nurse practice act. If hospital policy prohibits you from executing a function, you should not be asked to perform it, absent truly extraordinary circumstances.

Some employee manuals contain specific steps that a nurse should take if she is assigned a task beyond her qualifications. Many also follow the guidelines of the Nevada nurse practice act in detailing the responsibilities of various levels of nurses, and could provide guidance for you if an assignment is beyond the scope of your position. Similarly, if the Nevada nurse practice act forbids a nurse at your particular level from performing a particular task, you have solid grounds for refusing the assignment.

Although you may not have a copy of the act on hand, you can call the Nevada State Nursing Board for guidance. Alternatively, every nurse should have at least a passing knowledge of the scope of nursing practice allowed her by the practice act, so take the time to briefly review these regulations. While defining the scope of practice allowed to various types of nurses, the Nevada nursing regulations also contain specific prohibitions on nurse functions. For instance, a licensed practical nurse may not independently carry out those duties which require the substantial judgment, knowledge and skill of a registered nurse.

Referring specifically to these regulations when dealing with the administration will often have the effect of prompting a supervisor to change your assignment.

Though not legally binding in Nevada, decisions from courts of other states have upheld the right of a nurse to refuse to float to a patient care area in which she was unskilled and untrained. Winkelman v. Beloit Memorial Hosp. It is likely against public policy for an employer to attempt to terminate an employee for refusing to participate in care that conflicts with the law, as established in the nursing regulations. If you feel that you must unwillingly perform a task for which you are unqualified, document the event.

State the facts, including your objections and the reasons for them, with the emphasis on adequate patient care, and ensure that you state that you were willing to accept an alternative assignment and that you want to be trained on the specific task so that you can perform it in the future.

Then give a copy of the memo to the person who assigned you the task, your supervisor, and an appropriate administrator. Obviously, do not employ this strategy except in cases of potentially egregious violations of a patients interests, or when your own interests are in serious jeopardy. There is a significant difference from an employers perspective between a nurse who simply refuses an assignment because she says she does not feel qualified, and a nurse who voices a good faith objection to an assignment based on the interests of the patient and the institution and, of course, the nurses own legal interests , while offering to perform alternative assignments or offering to become trained on the assignment in a reasonable time.

Significantly, courts have upheld the firing of a nurse who refused to float to a unit with which he was unfamiliar when he refused the hospitals offer to orient him to that unit and any other units in which he could be asked to float. Francis v. Memorial General Hosp. In an emergency situation, a nurse should naturally do whatever is necessary to stabilize the patient.

Nevada law appears to allow registered nurses a greater scope of practice in emergency situations than under normal working circumstances.

NRS The legal standard of care changes slightly in an emergency situation; a nurse is required to act with the level of professionalism of a reasonably prudent nurse in an emergency situation. Any objections that a nurse has to her assigned task can usually be reserved for after the patient is stabilized.

Nurse supervisors similarly face potential liability for making assignments and delegations that are beyond the scope of the abilities of the person to whom the task is assigned. In general, a registered nurse or a licensed practical nurse may not delegate a task to a person who is not authorized to perform that task. Thus, a nurse may not delegate a task to a person if that task is beyond the scope of practice of the person to whom it is assigned.

In addition, a nurse who delegates tasks is usually responsible for the performance of the assigned work, thus potentially doubling the liability of a nurse supervisor. The tort of negligent supervision often includes within its scope the idea of negligent assignment.

Liability will be imposed on a nurse manager who fails to properly supervise a nurse to whom a task was assigned, particularly if the nurse manager was aware, or should have been aware, that the employee was not competent to perform the task. Clearly, if a nurse employee indicates that she is unqualified to perform a procedure, the supervisor will have received the requisite knowledge of incompetence that could lead to liability.

Nevada nursing regulations are very specific in only allowing a registered nurse to delegate care to other nurses or persons if those persons are qualified to provide that care. In addition, a registered nurse who is responsible for the management of other personnel under her management a chief nurse , must:.

Clearly the law holds a supervisory nurse to a high standard when she assigns or delegates tasks. It is therefore advisable that a nurse supervisor not only ensure the competence of her nurses before assigning tasks, but also listen very carefully to any objections or reservations expressed by a nurse who is assigned a task she feels incompetent to perform.

Similarly, a licensed practical nurse who delegates nursing care to another LPN or other person is responsible for the actions taken by those persons in carrying out the duties delegated or assigned. Again, it is critical that nurses of all levels ensure that a person is competent before she assigns a task and that any reservations that are voiced are carefully evaluated.

When supervising another nurse, be aware of potential problems before they surface. Send a memo to the appropriate supervisor and administrator stating that you were forced to assign unqualified individuals to tasks unsuited to their skills.

If appropriate, communicate to other personnel that a unqualified individual will be performing a task and will require additional supervision and assistance. In addition to legal liability for negligent selection assignment and negligent supervision, nurse managers and supervisors face disciplinary action from the Nevada State Board of Nursing.

Even if a patient is not harmed, a nurse may be disciplined for assigning or delegating functions, tasks or responsibilities to unqualified persons. Another section of the same regulation states that failing to supervise a person to whom functions of nursing are delegated or assigned will be considered unprofessional conduct that will be disciplined.

A nurse does not have to accept an assignment that conflicts with her personal ethical standards. In particular, issues such as abortion, DNR orders, and the withdrawal of nutrition may pit a nurses conscience against the demands of her job. Although a nurse does not have to perform ethically repugnant tasks, there is a correct, sometimes legally necessary, way to refuse such assignments.

As much as is practical, try to make your ethical opposition on certain issues known in advance. Ask that you not be assigned to those tasks that offend your conscience. It is far easier on you and your supervisor if you are never assigned to a problem task, than if you request to be pulled from the task once assigned.

A nurse is legally responsible for the care of the patient and cannot, under any circumstances, endanger the patient or abandon him.

Although courts sometimes uphold the right of a health care provider to not deliver morally objectionable care, no court will condone the abandonment of a patient, even for valid ethical reasons. Therefore, if a change in a patients status or condition requires that you perform a task that you cannot perform in good conscience, you are nonetheless responsible for him until adequate arrangements can be made for his continued care.

If changed conditions make it impossible for you to continue to ethically provide care for a patient, it is important that you immediately communicate this fact to a supervisor so that alternative arrangements can be instituted as soon as possible. Similarly, in emergency situations, a nurse has a moral and legal obligation to provide care that overrides her moral objections to the care.

In everyday circumstances not involving continued care or emergencies, ensure that you follow your employers guidelines for turning down an assignment for moral reasons. Clearly state or, better yet, document, your reasons for refusing to participate in the task, and ensure that your refusal is based on religious, moral, or ethical grounds. Nurses who belong to a union may also have an additional basis for turning down an assignment for ethical reasons — the employment contract.

Many union employment contracts have an exception that allows nurses to object to duties they find unconscionable without facing work-place repercussions. Because freedom of religion is guaranteed by both the U. Constitution and the Nevada State Constitution, which guarantees the free exercise of religious beliefs and worship without discrimination or preference, nurses whose religions prohibit them from certain practices are protected.

Negligence with nurses floating

Negligence with nurses floating