Question:

Dear Nancy,

Where can I find the laws about staffing and refusal to accept assignments based on staffing?

Rozelle

Nancy Brent replies:

Dear Rozelle,

The issues of staffing and refusing to accept an assignment based on staffing have been discussed in previous responses in this column. Reviewing those questions and responses might help identify information in the areas in which you are interested.

One issue concerning staffing that has not been recently addressed in this column is the issue of how “understaffing” affects the safety of the nursing staff when providing care to patients. In a recently reported case (Legette v. Scotland Memorial Hospital [North Carolina Court of Appeals, February 6, 2007]), as reported at Nursing Law’s Regan Report 10 (March 2007), one can learn how one appellate court analyzed a nurse’s injury due to “understaffing.”

The plaintiff, Ms. Legette, had been an RN since 1971. In October of 2000, she began working for Scotland Memorial Hospital. She was caring for a heavy, non-ambulatory patient who needed to be repositioned. Because the unit/hospital was “understaffed,” Legette repositioned the patient herself. When moving the patient, Legette experienced a “sharp pain” underneath her arm and shoulder. Despite this pain, she finished her shift and worked a second shift, taking Ibuprofen for her pain and the swelling of her arm.

When Legette returned to work the next day for her scheduled shift, she went to the ED with her shift supervisor. The ED doctor prescribed a pain medication that she did not want to take while working. Legette then filed a workers’ compensation claim, but the initial decision of the deputy commissioner was that the injury was not work-related. Legette asked for the full commission to hear her claim. The full commission allowed her claim to be re-opened and gave Legette a specific time period within which the deposition of her expert was to be taken. Over objections by the employer, the expert’s deposition was taken and testified that the diagnosis was lymphedema and that the injury was work-related. The commission granted Legget’s claim for workers’ compensation.

Scotland Memorial Hospital appealed the commission’s decision to the North Carolina Board of Appeals, which upheld the commission’s decision.

In addition to illustrating how “understaffing” may impact a nurse’s safety when working under such conditions (e.g., providing patient care alone when two people should be present to provide the needed help to a patient), the case also underscores the importance of nurses filing workers’ compensation claims when their injuries arise out of and during the course of employment. Regardless of the circumstances, a nurse who is injured on the job must follow the employer’s policy governing workers’ compensation claims — especially in terms of seeking medical care for the injury and in terms of filing a timely claim.

Sincerely,
Nancy

Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.