A registered nurse receiving an assignment that in her/his professional judgment places a patient(s) or themselves at risk has an obligation to take action. Acting in the interest of patients, the nurse should promptly notify her/his supervisor that because of inadequate staffing, the quality of care and the safety of patients and nurses have been jeopardized.
The Ohio Nurse Practice Act and the ANA Code for Nurses (ANA membership required to view) hold the nurse responsible and accountable to her/his patients for the nursing care provided. However, responsibility and accountability for the level of care also resides with the Hospital, including both Hospital and nursing administrative staff.
The accompanying "Assignment Despite Objection" (ADO) form may be used to document an assignment which is potentially unsafe for the patients or staff. This form should also be used to document concerns about potentially unsafe conditions that may arise when a nurse may be required to delegate inappropriately to unlicensed assistive personnel (UAPs). This will not exonerate you from liability or responsibility, but it will shift a great deal of the burden onto the shoulders of the Hospital, where it belongs.