As a licensed registered nurse, you have a legal and professional obligation to notify your employer of an unsafe situation so the problem can be corrected and injury or harm to the patient can be avoided. If, in your professional judgment, you believe a patient care assignment is unsafe, or potentially unsafe, an Assignment Despite Objection Form should be filled out. 

​Examples of when forms should be used:

• Can't reach a doctor for orders or admission

• Need for additional RN or support staff (e.g., PCA, unit clerk) 

• Changes (even temporary) to the staffing grid

• Lack of training or competency to handle patient care assignment 

• Mandatory overtime (being required to stay after scheduled hours) 

• Unsafe environment/workplace violence (hostile patient/family) 

• Skills mix on unit is insufficient 

Forms can and should be used as often as needed and may be filled out up to 7 days after the occurrence. It is illegal for management to discipline or retaliate against any nurse for filling out a form and advocating for ourselves and our patients. ​