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Case Study # 4

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Question 1

The main issue in the case against Winkelman was the fact that the hospital considered her rejection of an assignment as unacceptable according to company policy. Winkelman insisted that she was offered three choices by her supervisor which included the option of taking an unexcused absence day, but the supervisor objected. However, it is clear that both of them understood the situation well as Winkelman had explained the reasons why she could not float. In this context, the basis of firing Winkelman was unclear; although it seemed that she was fired for rejecting a task she felt she was not capable of doing.

Question 2

Nurses have a right to refuse an assignment. According to the West Virginia Board of Examiners for Registered Professional Nurses (2010), a nurse may reject an assignment when she/he feels that the task is beyond his/her professional scope, or if he/she is only allowed to perform the procedure under supervision. Accepting an assignment under these conditions is against the law and may lead to disciplinary action. It also puts the patient’s safety at risk which may lead to adverse outcomes including patient's death. Although a nurse has the right to reject an assignment, he/she should always prioritize patient safety and be prepared for disciplinary action from the employer.

Question 3

I do not agree with the hospital’s position on the issue of Winkelman. Although nurse’s actions warranted disciplinary action, the hospital was wrong to terminate her employment. She had explained herself clearly to the supervisor and it made sense that she could not accept the task as she felt she was not competent enough (West Virginia Board of Examiners for Registered Professional Nurses, 2010). However, given the three options she stated, Winkelman should have considered finding someone else to attend to the patients rather than going home as such actions may compromise the quality of care.

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