Rights of Registered Nurses when Considering a Patient

The American Nurses Association (ANA) position statement on "Rights of Registered Nurses when Considering a Patient Assignment" outlines the rights of registered nurses (RNs) to refuse assignments that they believe are unsafe or unethical. The statement also provides guidance on the factors that RNs should consider when making decisions about whether or not to accept an assignment.

Some of the legal and ethical implications of accepting assignments include:

• The RN has a duty to provide safe and competent care to their patients. This means that the RN must be able to assess the patient's needs and provide the appropriate care. If the RN does not believe that they have the skills or experience to provide safe care, they have a right to refuse the assignment.
• The RN has a duty to protect their own health and safety. This means that the RN should not accept an assignment that they believe is unsafe for themselves or their patients. For example, an RN should not accept an assignment if they are not properly staffed or if they do not have access to the necessary resources.

• The RN has a duty to advocate for their patients. This means that the RN should not accept an assignment that they believe is not in the best interests of their patients. For example, an RN should not accept an assignment if they believe that the patient is not receiving the appropriate care.

When delegating assignments to unlicensed personnel, RNs must consider the following issues:

• The skills and experience of the unlicensed personnel. The RN must ensure that the unlicensed personnel have the skills and experience necessary to complete the delegated tasks.
• The supervision that will be provided. The RN must provide adequate supervision to the unlicensed personnel to ensure that the tasks are completed safely and competently.
• The policies and procedures of the facility. The RN must ensure that the delegation is in accordance with the policies and procedures of the facility.

Insurance issues that come into play when delegating assignments include:

• The RN's malpractice insurance may not cover them if they delegate an assignment that results in harm to the patient. This is because the RN is still ultimately responsible for the care of the patient, even if they delegate tasks to unlicensed personnel.
• The unlicensed personnel's insurance may not cover them if they are injured while performing delegated tasks. This is because the unlicensed personnel are not typically considered to be employees of the facility, and they may not have their own insurance.

The legal principle of Respondeat Superior states that an employer is liable for the torts of their employees committed within the scope of their employment. This means that if an unlicensed personnel injures a patient while performing delegated tasks, the RN's employer may be liable for the damages.

In conclusion, RNs have a number of rights and responsibilities when it comes to accepting assignments and delegating tasks to unlicensed personnel. RNs must carefully consider the legal and ethical implications of their decisions in order to protect themselves, their patients, and their employers.