Clinical Connection: Safe vs. Unsafe Patient Assignments

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Welcome to the third episode of the Clinical Connection series. In episode three, we discuss safe versus unsafe patient assignments — what’s the difference, how to avoid unsafe assignments, and what to do if you do find yourself in an unsafe assignment.

Check out episode three, let us know what you think in the comments, and be sure to suggest any ideas for clinical-related topics or issues you’d like us to cover in the future!

Video Transcript: Hello, and welcome to Medical Solutions Clinical Connection. My name is Amber Gibson, my background is in emergency medicine and as an administrative house supervisor. Today I’d like to discuss safe versus unsafe patient assignments, and what those terms really mean, and how to avoid taking an unsafe patient assignment.

Travel nurses are expected to help the facility and their core staff by filling in gaps in staffing. However, they’re also expected to provide safe patient care. During stressful and high census situations, patient assignments can become very challenging, sometimes making it difficult to determine what is a safe patient assignment.

So, what is considered a safe assignment? Some orientation to the unit is provided, the nurse has suitable experience related to that patient population, there are basic supplies and resources available, and a reasonable, safe nurse-to-patient ratio is assigned. This is subjective in all states except for California. It’s up to the facility’s discretion, and it involves factors such as support staff and acuity levels.

You’ve been given an unsafe patient assignment, now what? According to the American Nurses Association, nurses are professionally and ethically obligated to advocate for their patients and themselves by voicing any concerns about patient assignments. So, here’s how to react in that situation. In a professional manner, state the case for why this is an unsafe patient assignment for you, and then you can collaborate with the supervisor to determine a solution. Can another arrangement be made? Could they float another nurse with that experience, and you go somewhere else that you have experienced in? Could you float there while another nurse handles specialty tasks? For example, a med surg nurse is floated to an oncology unit, but you would have another chemo certified nurse administer the patient’s chemo.

Here are some more tips to help keep you and your patients safe by avoiding unsafe patient assignments. Before signing a contract, find out what the floating requirements are, including the specific units you could be sent to. Facilities may say they float nurses to like units, but what does the facility consider a like unit? Make sure the units you are comfortable floating to are outlined in your contract so there’s no questions later. If you are floated, get information on the assignment before you report to the other unit. If you accept an assignment, receive report, and then decide it’s an unsafe and refuse it, you could run into issues with patient abandonment.

Unacceptable reasons for refusing an assignment include not personally agreeing with reasonable, safe protocols, or personality conflicts. The patients are the priority, and personal issues should be set aside. And remember, your recruiter and the Clinical Team are always here to you, so feel free to reach out any time.

Also, if you have any thoughts on today’s topics, more tips, or stories you’d like to share, please share those in the comments below. Thanks for joining me for Medical Solutions Clinical Connection, and we’ll see you next time.

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