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- QUESTION
A nurse employed by a temporary agency is assigned to a neurology unit for a 12-hour shift. On arrival, she discovers that the registered nurse (RN) assigned for the shift called in sick, leaving her with two nursing assistive personnel (NAPs) to provide client care and administer medication, including controlled substances. The nursing supervisor informs her that she will be responsible for the unit with 22 clients, 12 of whom are acutely ill and require close observation and frequent care. The nursing supervisor is not available to work on the unit and has no additional RNs to provide client care. The nurse decides not to accept the assignment, to report the decision and reasons to her agency supervisor, and to leave the neurology unit immediately before starting the shift.
Questions;
Thinking
In addition to protecting her nursing license, what other factors should the nurse have considered in deciding whether to stay on or leave the unit?Because the nurse decided not to accept the assignment, would this have been considered abandonment?
What standards, guidelines, and laws would apply to determine whether the nurse’s behavior was in accordance with standards of practice?
Critical Thinking
Which statements in the ANA Nurses’ Bill of Rights should the nurse have considered before deciding whether to accept the assignment?
What factors in this situation could create legal problems for the nurse?DOING
The nurse’s action (leaving the unit) might be viewed, under some laws in some situations, as abandonment of clients.
What are some alternative actions the nurse might have taken to avoid that risk?CARING
Have you ever been in a situation in which you felt a moral obligation to help, yet knew you would be in over your head? Describe your experience.In your opinion, did the nurse do the right thing when she decided not to accept the assignment and to leave the nursing unit immediately? Explain your thinking.
Rubic grading
30.0 pts
Level 4
Responses demonstrate in-depth thought and consideration for all factors
40.0 pts
Level 4
Content is thorough and opinions and arguments are backed by evidence.
20.0 pts
Level 4
Rationale provided for interventions and arguments is valid and reliable, backed by evidence.
10.0 pts
Level 4
Assignment is well written and thorough. No grammatical errors.Please do not link points to references. Only back them up with reference. And more less in-text citations please.
Thank you.
Reference;
Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2018). Basic Nursing: Thinking, Doing, and Caring(2nd ed.).
Russell, K. A. (2017). Nurse Practice Acts Guide and Govern: Update 2017. Journal of Nursing Regulation, 8(3), 18-25. doi:10.1016/s2155-8256(17)30156-4
Fowler, M. D. (2015). Guide to Nursing's Social Policy Statement: Understanding the Profession from Social Contract to Social Covenant.
| Subject | Nursing | Pages | 3 | Style | APA |
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Answer
Full Spectrum Nursing Model Case Study
Thinking
A nurse has an ethical and legal obligation to refuse an unsafe assignment that is likely to compromise the safety of the patient. In this particular scenario, the nurse had other several factors to consider in deciding whether to stay or leave the unit. The first factor to consider is the safety of the patients. While it important to note that her presence would save some patients, other patients are likely to suffer since she cannot manage all of them at the same time. Leaving would alert the management about the situation and necessitate the officials to look for other options. The nurse would also consider if she is qualified to take care of patients she is assigned to. Lastly, she would consider the available resources to take care of the patients.
Critical Thinking
Because the nurse did not to accept the assignment in this particular case, it should not be considered an abandonment. According to Treas and Wilkinson, (2013), the nurse cannot be said to have abandoned patients for whom she did not accept their responsibility. The same study reveals that abandonment is defined as a situation where a licensed nurse terminates nurse-patient relationship without any reasonable notification to the nursing supervisor for the continuation of care of the patient. However, nurse-patient relationship begins when the responsibility has been accepted by the nurse. In this particular case, that did not happen, hence it cannot be considered an abandonment.
Certain standards, guidelines, and laws would apply to determine whether the nurse’s behavior was in accordance with standards of practice. The first one is the American Nurses Association (ANA) code of ethics, which states that a nurse will be competent, accountable, use informed judgment, maintain employment environment to quality patient care, and collaborate with other health professionals to meet healthcare needs of the patient (Olson & Stokes, 2016). Additionally, Nurse Practice Act based on the state would be used to determine the nurse’ action. For example, in Florida, a healthcare provider is allowed to refuse an assignment when he/she lacks adequate knowledge and resource to ensure a positive patient outcome.
Some of the statements in ANA nurse bill right of that the nurse should have considered before deciding on whether to accept the assignment include (Olson & Stokes, 2016):
- Practice in accordance with professional standards and the nurse practice act
- Practice within an ethical framework, as specified by the terms of the Code of Ethics for Nurses
- A safe work environment
- Practice in a manner fulfilling obligations to society and patients
Doing
Certain factors in this situation could create legal problems for the nurse. The first is if the nurse could have accepted the responsibility and left without arranging for safe and proper care of the patient (Bastable, 2017). This could have been considered an abandonment. Second, if the nurse would have left without contacting authorities, particularly her agency, about the situation.
Since the action of the nurse could be viewed as an abandonment, she had certain alternatives to avoid the risk. First, she had an option to carefully look after the specific number of patients that she could adequately handle. Additionally, she could as well call the agency and inform them of the need for additional qualified nurses to assist her before deciding to refuse the assignment.
Caring
My experience of such a situation would result to emotional and moral distress since I would be unable to make a decision to assist the patient. Being unable to assist patients is one of the most tormenting experiences among care providers since they took an oath to protect and ensure safety of patients.
Based on ethical consideration, the nurse did not do the right thing when she decided not to accept the assignment and left immediately. I feel she should have opted for other options instead of giving up easily. One of the alternatives would be to press the agency to send more care providers to assist the situation.
References
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Bastable, S. B. (2017). Nurse as educator: Principles of teaching and learning for nursing practice. Jones & Bartlett Learning. Olson, L. L., & Stokes, F. (2016). The ANA code of ethics for nurses with interpretive statements: Resource for nursing regulation. Journal of Nursing Regulation, 7(2), 9-20. Treas, L. S., & Wilkinson, J. M. (2013). Basic nursing: concepts, skills, & reasoning. FA Davis.
Appendix
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