Thanks to the Safe Harbor for Nurses Act, protection for nurses rejecting certain assignments could be on the horizon
In a profession loaded with professionals who often feel overworked, a profession facing a well-publicized shortage that is projected to grow over time, it stands to reason that some nurses may receive assignments that don’t suit them as well as others. For example, imagine a NICU nurse being asked to report to the geriatric unit for a couple of months.
Many argue that’s part of what you signed up for—nursing is nursing, and you care for your patients to the best of your ability. But what if you think that ability isn’t up to standards? What if you truly feel you cannot provide adequate care to a segment of the patient population? Two choices:
- Refuse the assignment; risk disciplinary action (or worse)
- Take the assignment, all the while working in fear of making a catastrophic mistake
Thanks to the state of New Mexico, we can now suggest a third option. The Safe Harbor for Nurses Act protects nurses from disciplinary or ‘adverse’ action when nurses refuse an assignment on good faith. The actual phrasing is “makes a good faith request to be allowed to reject an assignment,” which sounds much friendlier.
First, the provisions:
According to Medscape, the law allows a nurse to reject an assignment on the basis of the nurse’s assessment of his or her education, knowledge, competence, or experience and the nurse’s immediate assessment of the risk for patient safety, or violation of the Nurse Practice Act or Board of Nursing rules. And the law only applies to entities with three or more nurses on their grounds and licensed by the Department of Health to provide healthcare. If you’re somehow the only nurse at your facility, this law hasn’t extended to your particular situation.
The law also provides for a conscientious objection of sorts in that a nurse can question the medical reasonability of another medical provider’s order. In other words, if you believe a doctor or physician’s request is not medically necessary, you can bring this to the attention of your supervisor, and together the two of you document the date, time, location and circumstances surrounding the request for safe harbor. The facility must conduct a review and cannot retaliate against the nurse for invoking the safe harbor.
Now, remember, if you’re reading this and not working in New Mexico, the law doesn’t apply. (Texas has a similar provision, which we’ll get to in a minute.) But is it realistic that this law could be coming to your state in the near future? A quick search reveals discussions in the states of California, Florida, and Michigan, to name a few, around this topic. It’s unreasonable to think the actions taken by New Mexico and Texas won’t at the very least receive adequate attention from Nursing Boards in other states.
About the Texas law:
Texas nurses may also invoke safe harbor, but only by filling out an official form and submitting to the facility, at which point the peer review committee has 14 days to make a determination about the situation.
The nurse may take the assignment or perform the service during the 14-day period unless the assignment is one that the nurse lacks the skills necessary to competently perform. The nurse may not leave the facility without collaborating with a supervisor, and the facility, in turn, may not retaliate against the said nurse.
Unlike New Mexico, the Texas law requires the facility to have eight or more nurses available. Like New Mexico, the law has been extended to include medical reasonability provisions.
Obviously, the two laws have their advantages and disadvantages, and it will be interesting to see which of the two states’ Safe Habor models is followed more closely in the creation of any possible additional laws.
Thoughts? Questions you’d like to see answered on Safe Harbor Laws? Email Rob Senior at firstname.lastname@example.org and we’ll do a follow-up this summer.