Subject: Student Success

Policy: STUDENT REFUSAL OF A CLINICAL ASSIGNMENT

Revised: March 2017; Spring 2023

Effective date: Fall 2023

Review date: Fall 2026

Responsible Party: Level I: UAAC/GAAC; Level II: Associate Dean for Academic Affairs

Introduction and Purpose

The primary aim of the College of Nursing is the education of persons for professional nursing practice. Students must know and follow established guidelines for professional practice consistent with the American Nurses’ Association Code of Ethics (2015), International Council of Nurses Code of Ethics (2012) and The Essentials: Core Competencies for Professional Nursing Education (American Association of Colleges of Nursing, 2021), “Nurses are obligated to care for patients in a nondiscriminatory manner, with respect for all individuals. The ANA recognizes there may be limits to the personal risk of harm nurses can be expected to accept as an ethical duty. Harm includes emotional, psychological, physical, or spiritual harm” (American Nurses’ Association Position Statement on Risk and Responsibility in Providing Nursing Care, 2015). Refusal to participate in the care or treatment of a patient on the grounds of patient advocacy includes situations when the student feels that the treatment conflicts with the patient’s welfare or wishes.

Policy

A student is expected to provide nursing care to any assigned client for whom the student has been taught the content and skills to provide safe care. Nursing care is to be provided without prejudice or discrimination. The College of Nursing recognizes the right of students to request not to participate in certain aspects of patient care or treatment under certain circumstances. Refusal to participate in the care of a patient is only appropriate on the grounds that: i) the student has not been taught the content and skills to perform the task; ii) patient advocacy; iii) moral objection to a specific type of intervention; or iv) significant risk to the health of the student. A student may not refuse to participate in the care or treatment of a patient based solely on the patient’s diagnosis or unique attributes.

Procedures

The following procedure applies to refusals over the entire program, not just in a

single clinical course.

 

Request for Religious and/or Ethical Reasons

 

1. A student who refuses to provide nursing care to a client will have a conference with the faculty making the assignment. Discussion will include the reasons for refusal and a plan to deal with similar patient assignments in the future. The student will provide a dated written request which includes aspects of the care or treatment of a patient from which the student is requesting to be excused and the basis for the request (e.g., religious accommodation, etc). If the request is based on a religious accommodation, the Campus

Director and Associate Dean for Academic Affairs shall consult with the Office of Institutional Equity prior to approving or rejecting the request and provide disposition of the request in writing to the student. If possible, a comparable assignment to meet course objectives will be given for that clinical day. A note summarizing the refusal and conference, the written request, and administrative written disposition will be placed in the student's academic record.

 

2. If a nursing student refuses to provide nursing care to an assigned client outside of the above criteria or approved exceptions, the faculty members and Campus Director, in consultation with the Associate Dean for Academic Affairs may remove the student from all clinical settings as per MRJCON Policy, Removal of Students from Clinical Settings.

Internal control considerations, if applicable:

How to ensure adequate safeguarding of assets, e.g. segregation of duties, misuse or fraud, etc.