By Ericka Waidley, MSN, RN
October 21, 1999

Q: After working a 12-hour night shift taking care of adults and pediatrics, I was told that I could not leave because there were no replacements. I was told I would be abandoning my patients and would not be replaced until they were able to find a pediatric nurse. Is this legal? I understand the abandonment problem, but what about patient safety?

A: This is a difficult situation to address because there are always two sides to every problem. In this instance, the hospital and management personnel have a commitment to provide adequate staff to meet their patients’ needs. On the other hand, you are probably tired and may feel you can’t provide the best possible care.

As a professional nurse, you are the best judge of your own capabilities related to providing care to an assigned group of patients. Although your manager may need you to stay until another nurse can take over your assignment, you are the best judge as to whether you can continue to provide safe care in a mandatory overtime situation. If you honestly feel that you are too tired to continue providing safe care, then you need to tell your supervisor. At this point, the supervisor may look at rearranging assignments, pulling a nurse from another unit, taking a temporary assignment herself (until more help arrives), or readjusting your assignment.

Even with all of these options, someone has to take care of the patients. It is legal to request mandatory overtime and often it is included in the human resources policies. You should review your employee handbook or check with your human resources department to see what the policy of your hospital is regarding mandatory overtime. If there is a documented policy, then you signed your agreement with these policies when you received your handbook/orientation. However, it is important for you to know that according to the BRN, refusal to accept an assignment is not considered patient abandonment. You are not obligated by your license to stay beyond the shift you agreed to work, but you may be obligated by your employment agreement.

There are always alternatives to consider before implementing the mandatory overtime policy. Good communication between management and staff is imperative when staffing shortages occur. Often, staff members themselves can come up with good ideas that are creative solutions to staffing problems. You can call the BRN for a copy of its statement on patient abandonment, (916) 322-3350.

Q: I am a BSN graduate from the Philippines. I would like to start a career in military nursing in the United States, but my foreign education disqualifies me from becoming an officer. How can I get my college credits evaluated and possibly accredited by a U.S. college of nursing?

A: You have several options for becoming an officer in the U.S. military. Your information is correct, however, in that you cannot be an officer without graduating from a U.S. college program. Each branch of the military may be a little different in structure, but the basic process and educational requirements seem to be similar. My information comes from the recruitment offices for the U.S. Navy and U.S. Army.

The easiest way to get your college credits evaluated is to go to the recruitment office of the military branch you are most interested in joining. I found these representatives very helpful, but they all said that they evaluate each applicant to their training programs on an individual basis. If you are accepted into their training programs, both services will help you get your Philippine college credits reviewed at a local college nursing program. After this review, a one to two-year curriculum plan will be established so you can complete your BSN from an accredited college in the United States. After you have graduated and passed your state boards to become an RN, you are automatically recommissioned as an officer. The good news is that you can go to school full time and be paid by the service at an enlisted rate at the same time.

Another way to pursue your military career is to join the service as a hospital corpsman (Navy) or as a medical specialist (Army). These are both enlisted ranks, but you would gain work experience, get paid as an enlisted person, and still apply to the commissioning program to continue your schooling and advance to officer status (once you have graduated from the nursing program and passed your state boards as outlined above).

Both the Army and the Navy have an age limit for those applying to their nursing training programs: You cannot be older than 27. I would recommend that you talk to a recruiter for the service branch of your choice and let them help you evaluate your career options.