ANA Taking Comments on New Statement of RNs' Refusal Rights

The new statement says RNs have the right to accept, reject, or object in writing to "any patient assignment that puts patients or themselves at serious and immediate risk for harm."

The American Nurses Association's Congress on Nursing Practice and Economics began seeking comments Wednesday on a new ANA position statement, "Patient Safety: Rights of Registered Nurses When Considering a Patient Assignment," which says this: "The American Nurses Association (ANA) upholds that registered nurses – based on their professional and ethical responsibilities – have the professional right to accept, reject or object in writing to any patient assignment that puts patients or themselves at serious and immediate risk for harm. Registered nurses have the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm. The professional obligations of the registered nurse to safeguard patients are grounded in the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001b), Nursing: Scope and Standards of Practice (ANA, 2004), and state laws, and rules and regulations governing nursing practice."

The statement replaces a 1995 ANA statement that also dealt with registered nurses' ability to accept or reject a patient assignment. Comments are due by 5 p.m. EST on Nov. 10 to Cheryl.Peterson@ANA.org. ANA represents a large number of the nation's 2.9 million RNs through its 54 member associations.

The supporting material for the statement makes it clear "unsafe" staffing is the chief concern, although the draft posted on ANA's Web site notes "Multiple factors contribute to an unsafe patient assignment."

The draft explains how and with whom to file an assignment objection form; including specific patient information could be a HIPAA violation if the information leaves the facility, it states. It also says 22 Texas Administrative Code 217.20 requires a health care employer with 10 or more nurses to permit a nurse who acted in good faith to request peer review when requested to engage in conduct the nurse believes violates his or her duty to a patient.

The draft also explains potential legal ramifications and disciplinary action that might follow a nurse's refusal of assigned work or filing of a patient assignment rejection form.

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