Case Scenario:
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.
Unfortunately, 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.
Critical Thinking Questions:
1. 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?
2. 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 or not the nurse's behavior was in accordance with standards of practice?
3. Which statements in the ANA Bill of Rights should the nurse have considered before deciding whether or not to accept the assignment? What factors in this situation could create legal problems for the nurse?
4. The nurse's action (leaving the unit) might be viewed as abandonment of clients under some laws. What are some alternative actions the nurse might have taken to avoid that risk?
5. 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.
6. 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.