She received an ASN from Angelo State University, a BSN and MSN from Queens University of Charlotte where she was recognized as the outstanding graduate student, and a PhD in nursing from University of Texas at Austin. Safe patient handling and mobility. American Nurses Association. https://doi.org/10.21916/mlr.2018.27, Dunton, N., Gajewski, B., Klaus, S., & Pierson, B. A nurse must invoke safe harbor before engaging the act in question. It is not enough to say that we want what is best for our patients; we must also do what is best for our patients. Despite this emphasis, nurses do not often consider how policy affects the professional nursing role (Taft & Nanna, 2008). Twenty two nurses were investigated by the Nevada State Board of Nursing for alleged violations of the Nevada Nursing Practice Act, notably failure to safeguard patients (Black, 2011). The Safe Harbor Rule (SHPR) is a nursing peer review process that any type of nurse (licensed vocational nurse or registered nurse) can initiate in good faith whenever asked to take part in assignments or conduct that might result in one or more violations of Texas Board of Nursing rules and statutes. Retrieved from https://infectioncontrol.tips/2016/06/15/insurance-pay-for-hais/, Willmann, J. Online Journal of Issues in Nursing, 12(3). The National Database of Nursing Quality IndicatorsTM (NDNQI). Protection failures represent opportunities for future advocacy. Bear, EdD, MSN, RN, CNE; Mindy L. Schaffner, PhD, MSN, RN, CNS. During the most recent legislative session, TNA leaders negotiated bill language with the Texas Hospital Association that would have required workplace violence prevention plans with input from direct care nurses. (2019). You submit it to the BON. Be polite and factual when you follow the chain of command through the charge nurse, unit leader, or nursing office. When considering how to proceed in a difficult legal, ethical and professional situation, solid advice grounded in the law, which is backed by the American Nurses Association, is the best way to proceed. Acqeisising and accepting unsafe or inappropriate practices is equivalent to condoning unsafe practice. (Prov. Listen carefully, consider all available options, and thank the nurse for having the courage to speak up. I had a very similar question from another nurse recently where the NICU nurses were being used as sitters due to reduced NICU census. As chief executive of the Texas Nurses Association, Cindy leads the strategic operations of the Texas Nurses Association, a professional membership organization of registered nurses that empowers Texas Nurses to advance the profession. This database became a powerhouse of information for researchers interested in studying relationships between nursing staff characteristics and patient outcomes (Dunton, 2007). The association of registered nurse staffing levels and patient outcomes: Systematic review and meta-analysis. Nurse executives should support nurses who exercise their rights to protect their licenses and not view safe harbor requests as an affront to their leadership. Although both bills failed to pass in 2011 (Willmann, 2011), similar legislation enhancing penalties for assault of emergency department personnel passed in the next legislative session (Willmann, 2013). The statute was implemented in 2004. Solving tough problems through innovation and proven methodology. This example represents a missed opportunity for nurses to change practice through policy. They participate in operationalizing and implementing emergency preparedness plans within their organizations, they work additional hours, they volunteer at shelters for displaced medically fragile persons, and they coordinate medical supplies, blood donations and other vital resources. Decide on what kind of signature to create. (BJ) Strickland is from Tennessee. However, we recognize that there are stories from every state that highlight the valuable work of many nurses that illustrate individual and collective nursing organization advocacy. Every nurse should be aware of the statutes and rules governing their profession. This includes protections for whistleblowers. (15) Safe Harbor--A process that protects a nurse from employer retaliation, suspension, termination, discipline, discrimination, and licensure sanction when a nurse makes a good . Given the outcome and scope of the outcomes of successful advocacy, and the failure to advocate discussed above, it is important to address the need for advocacy protections. We expect the successful candidate to be able to configure and customize Microsoft Dynamics 365 CRM applications using a variety of technologies. Journal of Nursing Administration, 42(10), Supplement: S10S16. If you log out, you will be required to enter your username and password the next time you visit. I am not qualified to care for these patients because I dont have the knowledge or the experience. She has practiced law in state and federal courts in Tennessee since 1996 with an interest in healthcare risk management, employment law and medical malpractice. Your license is not a free pass for employers to use you anywhere they feel a need. Legislative update: TNA protects nurses in 84th session. As we begin 2020, designated by the World Health Organization ([WHO], 2019) as the Year of the Nurse and Midwife, policy change remains among the most effective approaches to create the circumstances for the right thing to be done. American Journal of Nursing, 111(6), 26-35. doi: 10.1097/01.NAJ.0000398537.06542.c0, Brigham, C. J. While many nurses recognized the reuse practice as inconsistent with safe infection control practices, complacency among coworkers and fear of retaliation inhibited reporting of concerns. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingWorkforceCharacteristics.html, Jones, T., Bae, S. H., & Murry, N. (2015). The nursing profession has a long history of nurses influencing decisionmakers to make positive change in health policy. What do you do? Nurses are not always in control of the care they provide, so its important that everyone understands the terms of safe harbor and when it may be invoked. To err is human: Building a safer health system. Everywhere industry meets environment, Clean Harbors is on-site, providing premier environmental and industrial services. This was the latest of many staffing incidents at this facility. Safe Harbor (SH): A process that protects a nurse from employer retaliation, suspension, termination, discipline, . (2015). Texas Nursing Voice, 7(3): 1, 3-4. The facility may not retaliate against the nurse who invokes the safe harbor. Ellen began her clinical practice in neuroscience nursing and for the past 20 years has focused on healthcare quality across the continuum of care from acute care hospitals, to community-based mental health, home care, and hospice. A new law in New Mexico gives nurses another option. Follow the step-by-step instructions below to design your safe harbor request form: Select the document you want to sign and click Upload. The Figure offers additional information about Texas patient advocacy and whistleblower protections. If the nurse files Safe Harbor and the reason is to prevent unsafe care for patients' then the nurse should theoretically be safe from retaliation, but if the nurse is only protecting themselves or their license then the BON will offer little protection from consequences at their facility. They are not providing any cross training at all. An existing policy of enhanced criminal penalties for assaults against first responders, such as peace officers, firefighters, and emergency medical service workers (which elevated the seriousness of the offense from a misdemeanor to a felony) inspired a similar approach to deter violence against nurses. Board Rule 217.20 is the Board's rule concerning safe harbor nursing peer review, and 217.20(e) outlines the requirements the nurse must meet in order to secure the protections, . Table. R. L., Shamliyan, T. A, Mueller, C., Duval, S., & Wilt, T. J. (2004). This law requires hospitals and nursing homes to adopt policies and procedures for the safe handling of patients that control the risk of injury to patients and nurses associated with the lifting, transferring, repositioning, or movement of a patient. (Texas Senate Bill 1525, 2005). Cindys nursing career spans advanced practice, chief nurse executive, and academic roles. Protections can be eroded through subsequent legislation or agency rules, and enforcement mechanisms may be weak or non-existent. And now nurses can also use oral safe harbor when they are unable to stop what they are doing to fill out forms. Nurses who accept or make assignments must consider patient safety. Protections are imperfect, but that does not diminish their importance. Florence Nightingale to her nurses: A selection from Miss Nightingales addresses to probationers and nurses of the Nightingale School at St. Thomas Hospital. A place where registered nurses and nurse practitioners offer helpful videos and articles and advice to other nurses. Often policy change involves an incremental approach that requires persistence. No nurse, from a patient safety and legal liability standpoint, should ever be assigned primary care responsibility for patients that they are unqualified to care for yes, your license says you MAY care for these patients BUT that is only AFTER youve had training and supervision. The BON Comprehensive Written Request for Safe Harbor Nursing Peer Review Form is a sample form that may be used to document the more in-depth information that the nurse must put in writing before leaving the work setting at the end of the work period. As Director of Practice of the Texas Nurses Association, Ellen supports nurses efforts to influence policy through member engagement and assistance, collaboration, and communication. This article will begin by briefly addressing the role of nurses in advocacy to advance professional practice, and offer background information about the changing healthcare industry that has influenced the example of advocacy we discuss. Journal of Nursing Administration, 38(5): 223229. 2022 American Nurses Association. Name of person/supervisor (and title) making assignment or requesting the conduct: 5. The federal government provided $4.7 million for this project through CMHC as part of the Canada - Quebec Agreement on RHI. It is Christmas Eve and you report to your unit to work the night shift. Nurses have an ethical imperative to engage in policy. Nurse(s) Name(s) invoking Safe Harbor: 2. Nurses who accept or make assignments must consider patient safety. To ensure policies are effective, the impact on nursing practice must be evaluated to make certain policies are having the desired effect and have not created unintended consequences. 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