Nurses can fix the problems in nursing without using collective bargaining tactics. It is important to remember that the Safe Harbor laws are not to protect nurses. The Safe Harbor and Peer Review process allow nurses a great deal of comfort in their practice by assuring a procedural manner for objecting to unsafe practices. Such administrators may serve as fact witnesses, however. The Texas Board of Nursing has provisions in place to protect nurses that feel they are in an unsafe situation.
Group One is the name of this organization. Under such circumstances, the due process requirements discussed in this article will not apply. An employer or supervisor cannot deny a nurse the right to invoke Safe Harbor whether the nurse accepts or refuses the assignment. So my question is this: Where in the world do I turn for some advice or advocacy? However, a gray area sometimes exists in different areas of nursing where individual nurses may hold inconsistent views regarding what counts as 'safe' and 'unsafe' practice. I suppose it's better than nothing, but what happens if the board decides against you? Additional documents may be submitted to the committee when available at a later time; and E the nurse's name, title, and relationship to the supervisor making the assignment or request. A detailed written account of the safe harbor request that meets the minimum requirements for the Comprehensive Written Request for Safe Harbor Nursing Peer Review described in paragraph 4 of this subsection must be completed before leaving the work setting at the end of the work period. Do you feel protected under Safe Harbor? The content of this notification must meet the requirements for a Safe Harbor Quick Request described in paragraph 3 of this subsection.
This includes documentation of individual training and competency, procedures to be performed, physician order to initiate, and appropriate medical and nursing back up. For more information, please contact our office at 979-436-0390. Doesn't Texas have some group I can't recall the name of it that blacklists nurses and makes it very difficult for them to get a job if they are put on the list? A nurse requesting safe harbor in compliance with 303. The fundamental problems are never corrected. It's not only unfair but callous of management to expect nurses to continue to function in situations were either patient or staff safety is jeopardized.
If a nurse knows, or should have known, that a client was potentially in danger, the nurse's duty is always to act in the best interest of the patient. And according to the Texas Board of Nursing website, Safe Harbor also has a structured process for nurses to request that a determination be made on the medical reasonableness of physicians' orders. At least three-fourths of the members on a nursing peer review committee must be nurses. I am not any spring chicken - retired and went to nursing school because I wanted to serve God. The reality of it is that we are well educated professionals who can stand together to make the necessary changes. It's not only unfair but callous of management to expect nurses to continue to function in situations were either patient or staff safety is jeopardized.
Lastly, nurses are accountable to hold proper credentials e. Each position statement is meant to provide guidance in the context of the totality of the position statement. The hospital's chief nursing officer accepted the findings of the committee and made changes by assigning two more full-time nurses to night shift on the chemical dependency unit for a grand total of four nurses for 35 patients. I had never been written up and had never been late. Some states include a provision in their nurse practice act for nurses to resolve situations that they believe are unsafe or violate their duty to advocate for and protect the patient. See evidence-based practice standards of professional anesthesia association guidelines listed in the position statement 15. Have you invoked Safe Harbor but then felt you were being punished? Reinsertion by a nurse is not recommended prior to 8-12 weeks post-initial insertion; specific physician orders must be obtained regarding reinsertion by a nurse.
Using e-technology and telecommunication we conduct quality reviews and, when necessary, facilitate nursing peer or safe harbor reviews consistent with requirements of the Texas Board of Nursing. Wouldn't said nurses that speak up end up on that list? Nurses who accept or make assignments must consider patient safety. Such policies tend to be lengthy, unclear, and useless. Also, a list of criteria is included in order for nurses to show accountability for the care they provide. To activate protections outlined in Texas Occupations Code 303. This must be done prior to engaging in the conduct or assignment for which safe harbor is requested and at any of the following times: i when the conduct is requested or assignment made; ii when changes occur in the request or assignment that so modify the level of nursing care or supervision required compared to what was originally requested or assigned that a nurse believes in good faith that patient harm may result; or iii when the nurse refuses to engage in the requested conduct or assignment.
Is the Safe Harbor provision an effective tool for nurses? Shared Governance is a good idea in concept, as is peer review, but to say that that answer is a union is not the answer. Although we have the Safe Harbor rule, management at many facilities strongly discourages nurses from utilizing this protection to avoid dealing with the ensuing peer review. The review includes whether external factors beyond the nurse's control may have contributed to any deficiency in care by the nurse, and to report such findings to a patient safety committee as applicable. An instance of a successful Safe Harbor invocation: A freestanding psychiatric hospital has a census of 35 patients on the chemical dependency unit. The administration of drugs and monitoring of patients for moderate sedation may be within the Rn's scope of practice. A brief summary of Position Statement content is available, but does not capture the details contained within each Position Statement. Not a good time to be a nurse around here.
A nurse may carry out these orders provided the orders originate from a written protocol authorized by a physician. The state board failed nurses when they put a ruling out without first determining how it was to be safely and effectively implemented and managed. A facility may choose to initiate an informal review process utilizing a workgroup of the nursing peer review committee provided that the final determination of the nurse's duty complies with the time lines set out in this rule and there are written policies for the informal workgroup that require: 1 the nurse to: A be informed how the informal workgroup will function and that the nurse does not waive any right to nursing peer review by accepting or rejecting the use of an informal workgroup; and B consent, in writing, to the use of an informal workgroup; 2 the informal workgroup to comply with the membership and voting requirements of subsection h of this section; 3 the nurse to be provided the opportunity to meet with the informal workgroup; 4 the nurse to have the right to reject any decision of the informal workgroup and have the entire committee determine if the requested conduct or assignment violates the nurse's duty to the patient s , in which event members of the informal workgroup shall not participate in that determination; 5 ratification by the safe harbor nursing peer review committee chairperson of any decision made by the informal workgroup. Unfortunately, since your employment was terminated during the typical 90-day new hire probationary period, there's not much you can do. The rationale should refer to one of the justifications described in subsection g 2 of this section for not engaging in the conduct or assignment awaiting a nursing peer review determination.
If possible, reference the specific standard Rule 217. Like I said I am a new nurse. Board position statements are reviewed annually for relevance and accuracy to current practice, the Nursing Practice Act, and Board rules. At a minimum, attorneys must be able to confer with and advise their clients during the meeting. A nurse who knowingly participates in nursing peer review in bad faith is subject to disciplinary action by the Board. They are based in a suburb of Dallas. The two full-time night shift nurses believed that patient safety was placed in jeopardy due to the decreased staffing and ensuing increase in tasks.