Nurses: When Is It Okay to Say “No?”

As a nurse, you face challenges every day on the job. You are expected to assist physicians and follow their orders precisely as dictated. As such, you may occasionally find yourself in a position where you do not feel comfortable doing the job assigned to you and may want to say “no.” But is doing so advisable?

The following are some examples of tricky situations that you may encounter as well as advice about how they should best be handled.

You Are Asked to Stay Long after Your Shift Has Ended

We’ve all been there. You are ready to leave after a long and grueling shift and your supervisor asks you to stay on to cover for a staff shortage. There are a number of reasons why you may want to refuse. You may have children you need to attend to or may have made plans for later on that are important to you. After all, you do have a life outside of nursing. Another reason you may want to refuse is if you are simply too worn out and do not feel that you can adequately do an acceptable job. So what do you do?

Many states have laws that prohibit mandatory overtime, meaning that your refusal to work extra hours cannot legally have career-damaging repercussions.  In this case, explain your conflict or problem with working extra hours, and, if possible suggest an alternative solution. If, however, you live in a state where mandatory overtime is permitted, your agreement to stay beyond the end of your shift is implied in your employment agreement. You will need to get permission from a nurse manager or other administrator to leave. 

According to an article published by NurseTogether.com, “Mandatory overtime or any policy requiring nurses to work beyond their scheduled shift contributes to stress, errors, and burnout. While nurses may be concerned, their refusal to work overtime could affect their performance evaluation, lead to termination, charges of patient abandonment, or disciplinary actions to their professional nursing license.” It is therefore very important that you are aware of the terms of your employment before you refuse to work extra hours when asked.

You Are Given a Task for Which You are not Trained, Certified or Otherwise Qualified

If a physician or nursing supervisor orders you to do a job for which you are not qualified, you may feel that you are required to fulfill their request. However, accepting responsibility for such a job can have serious repercussions.

Lippincott’s Nursing Center published an informative article by Penny S. Brooke, APRN, MS, JD. In it, Brooke warns that, “as a nurse, accepting responsibilities that are beyond the scope of your license or skill level can have serious consequences for your, your patients, and your nursing career. Your state board of nursing can suspend or revoke your license and fine you if you don’t make the right decisions.”

If you find yourself in such a situation, you should not let others intimidate you into doing a job for which you are not qualified. Instead, you should refuse and explain your reasoning.  Jennifer Ward of Nurse Together recommends, “If you are not comfortable doing a specified job indicate that you would be willing to accommodate if you had the necessary training.” If you are penalized in any way for your refusal, you will have a legal foothold to appeal the penalty.

Be Assertive but Accommodating

Nursing is a difficult job. It can be made more difficult when you are put in difficult situations in which you want to say no to those in supervisory positions. When faced with a situation in which you want to say no, always be sure that you are clear about your reasoning and that you refuse the assignment in a decisive, yet empathetic way. Your coworkers and supervisory staff will appreciate you for it.