Nurses have an obligation to provide safe, competent and ethical care to their clients, in accordance with BCCNM’s Standards of Practice and relevant legislation.
If you think providing care would put you at risk, you may withdraw from providing care or refuse to provide care. Think about your legal, professional, and contractual responsibilities and use an ethical decision-making process to help you make the decision. The
Duty to Provide Care practice standard provides more information and guidance about your legal and professional obligations to clients.
It's important to work with the client, co-workers, and your employer to develop a plan that allows for client care and for your safety.
Nurses have a professional and legal duty to provide clients with safe, competent and ethical care, and the client has a right to receive care. Do not allow your personal judgments about a client, or the client's lifestyle, to compromise the client's care by withdrawing care or refusing to provide care.
While you cannot abandon your clients, do not put yourself or clients in situations where giving care might be a danger to personal safety - violence; communicable disease; physical, verbal, or sexual abuse.
Situations where the need for health care is greater than the available resources require your professional judgment and ethical decision making. You are responsible for providing safe, appropriate and ethical care to the best of your ability.
The following strategies may help you:
Work with the care team to assess client needs, staff capacity and available resources. Be sure to consider environment safety needs such as oxygen, suction, and access to call bells.
Set priorities, adjust client plans of care and care delivery as needed. This may include moving clients to ensure appropriate access to equipment or monitoring.
Identify and communicate any immediate safety concerns to the appropriate person, such as your supervisor or manager.
Explore whether discharging or transferring clients is an option. Include physicians in the discussion when appropriate.
Working with limited resources and
10 tips may provide further information and guidance for these situations. For further assistance contact
In this type of situation it is very unlikely that you would be reported to BCCNM. For BCCNM to become involved, a formal written complaint must be received, describing how a nurse’s unethical, impaired or incompetent practice puts clients’ at risk.
It’s important to remember that even in situations where you cannot provide optimal client care, you can still meet the Professional Standards. These situations are usually beyond your individual control and often require a systems approach for resolution. You are responsible for providing the best care possible under the circumstances. In these situations:
By following these steps, you are likely meeting your
Professional Standards and your obligation to provide clients with safe, competent, ethical care.
You’ll find more information and guidance in in the resource
Working with limited resources.
For further assistance contact
Your employer has a right to reassign you to another area. You were likely hired by an agency or health authority and cannot refuse to be reassigned.
Consider what care you can safely provide, while practicing within your level of competence. Clearly communicate this to the most appropriate person such as your immediate supervisor and discuss any concerns about your reassignment. Refusing a reassignment is generally justified only when the risk of harm to clients is greater if you accept than if you refuse. If you don’t have the competence to work in the assigned area, collaborate with others to determine the best option and follow up in writing.
Working in an unfamiliar practice area can be challenging and anxiety provoking. Using these strategies may help:
Working with limited resources may provide further information and guidance for these situations. For further assistance contact