ASSINGMENT DESPITE OBJECTION FORM
PURPOSE: The Assignment Despite Objection form is an enforcement document/form that helps to notify hospital supervision that you have been given an assignment which in your independent professional judgment is unsafe for your patients. This form will document the situation. Your DCNA-DBH representative will use it to facilitate resolution of the problem.
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PLEASE PRINT:
For a Printable Version: Click Here
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Check all appropriate boxes (more than one may apply). Please don’t forget to complete name of your unit/department and name of the person making the assignment. A copy of the ADO should be given to your Local Chair and Head Nurse/Nurse Manager. All ADO’s should be faxed to DCNA at 202-362-8285. Please retain a copy for yourself. You must notify your supervisor or the person in charge and the charge nurse. Continue to the next page to complete the ADO form online and have it automatically sent to DCNA.
KNOW THE APPLICABLE DC RULES & REGULATIONS
The practice of registered nursing means the performance of acts requiring substantial specialized knowledge, judgment, and skill based upon the principles of the biological, physical, behavioral, and social sciences in the following:
The observation, comprehensive assessment, evaluation and recording of physiological and behavioral signs and symptoms of health, disease, and injury, including the performance of examinations and testing and their evaluation for the purpose of identifying the needs of the client and family;
The development of a comprehensive nursing plan that establishes nursing diagnoses, sets goals to meet identified health care needs, and prescribes and implements nursing interventions of a therapeutic, preventive, and restorative nature in response to an assessment of the client’s requirements;
The performance of services, counseling, advocating, and education for the safety, comfort, personal hygiene, and protection of clients, the prevention of disease and injury, and the promotion of health in individuals, families, and communities, which may include psychotherapeutic intervention, referral, and consultation;
The administration of medications and treatment as prescribed by a legally authorized healthcare professional licensed in the District of Columbia;
The administration of nursing services including:
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Delegating and assigning nursing interventions to implement the plan of care;
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Providing an environment for the maintenance of safe and effective nursing care.
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Evaluating responses and outcomes to interventions and the effectiveness of the plan of care;
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Promoting a safe and therapeutic environment;
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A registered nurse may provide nursing services, which are beyond the basic nursing preparation for a registered nurse, if the registered nurse has the appropriate education, knowledge, competency, and training to safely perform the services.
A registered nurse shall not accept or perform professional responsibilities which the nurse is not competent to perform.
A registered nurse shall report unsafe nursing practice by a nurse that he or she has reasonable cause to suspect has exposed or is likely to expose a client unnecessarily to risk of harm as a result of failing to provide client care that conforms to the minimum standards of acceptable and prevailing professional practice. The registered nurse shall report such conduct to the appropriate authority within the facility, or to the Board.