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Accountabilities when refusing assignments or discontinuing nursing services
As nurses, your primary accountability is to patients. When deciding whether to provide care in a particular situation, exercise your professional judgment and follow an ethical decision-making process.
Abandonment occurs when a nurse accepts an assignment and discontinues care, without:
- the patient requesting the discontinuation
- arranging a suitable alternative or replacement service; or
- allowing a reasonable opportunity for alternative or replacement services to be provided
Nurses may be concerned that declining work could be considered abandonment. There are many situations that can lead nurses to think about refusing assignments or discontinue care. For example, working in practice environments outside of their knowledge, skill and judgement, workload issues or even workplace strikes.
When deciding whether to refuse an assignment or discontinue nursing care, you are accountable to:
- Assess the potential for harm to yourself and your patients
Consider the circumstances of the situation and your practice setting. Continue to work within your knowledge, skill and judgement and complete a point-of-care risk assessment.
- Use evidence-based sources to inform your decision-making and consider the context of the situation
- Communicate your concerns to your employer
Tell your employer that you are considering refusing an assignment or discontinuing nursing care. Discuss your concerns with your employer and consider their response. If, after doing so, you choose to refuse the assignment or discontinue care, work with your employer to develop a plan to ensure that safe patient care continues.
- Ensure your patient(s) continue to receive care
You must ensure that a suitable alternative for care is available for your patient(s) or allow reasonable time for alternate or replacement services to be arranged.
- Document your decision-making process, actions and decision
For more information, read the following resources: