Workplace Issues

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The Maryland Nurses Association (MNA) supports workplace advocacy strategies to promote a professional work environment for nurses in all practice settings. MNA supports nurses working collaboratively with their employers to make the workplace safe and conducive to providing quality patient care while enhancing professional nursing practice. Workplace advocacy supports the individual nurse in both professional and personal development helps the nurse address workplace challenges. MNA implements strategies on workplace issues through its Workplace Advocacy Committee and Legislative Committee and through the MNA Center for Ethics and Human Rights.

Accepting/Rejecting an Assignment
There may be times that the assignment itself appears to preclude safe care or requires you to practice beyond your scope. The BON takes action against nurses who fail to perform in a manner that ensures safe nursing practice. Behavior and activities that could lead to disciplinary action by the BON include:

  • Practicing beyond the scope permitted by the NPA.
  • Accepting a work assignment that the nurse is not competent to perform and/or failing to perform it completely.

If you find yourself faced with making a decision about accepting a work assignment, use this decision tree provided by the MNA to help determine your line of action.

The American Nurses Association's
Bill of Rights
For Registered Nurses

Registered nurses promote and restore health, prevent illness and protect the people entrusted to their care. They work to alleviate the suffering experienced by individuals, families, groups and communities. In so doing, nurses provide services that maintain respect for human dignity and embrace the uniqueness of each patient and the nature of his or her health problems, without restriction with regard to social or economic status.

To maximize the contributions nurses make to society, it is necessary to protect the dignity and autonomy of nurses in the workplace. To that end, the following rights must be afforded.

  • Nurses have the right to practice in a manner that fulfills their obligations to society and to those who received nursing care.
  • Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice.
  • Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses and its interpretive statements.
  • Nurses have the right to freely and openly advocate for themselves and their patients, without fear of retribution.
  • Nurses have the right to fair compensation for their work, consistent with their knowledge, experience and professional responsibilities.
  • Nurses have the right to a work environment that is safe for themselves and their patients. Nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings. 

Disclaimer: The American Nurses Association (ANA) is a national professional association. ANA policies reflect the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules and regulation govern the practice of nursing. The ANA's "Bill of Rights for Registered Nurses" contains policy statements and does not necessarily reflect rights embodied in state and federal law. ANA policies may be used by the state to interpret or provide guidance on the profession's position on nursing.

Delegation is the act of assigning or authorizing an unlicensed individual to perform acts of registered nursing or licensed practical nursing (COMAR 10.27.11). To delegate means that the registered nurse invests authority to act on behalf of the registered nurse herself to an unlicensed person and authorizes the unlicensed person to augment and supplement the care a registered nurse provides, however the registered nurse retains the accountability and responsibility for the delegated act.

Responsibilities of the registered nurse in delegation include: instruction, direction, evaluation of the performance of nursing tasks by the unlicensed person, rectifying a situation where the delegated task is performed incorrectly and to prohibit any unlicensed person from performing tasks incompletely.

The registered nurse has the right and responsibility to refuse to assign or delegate nursing tasks.

The registered nurse has the right to refuse to accept responsibility for supervising, monitoring, or evaluating an unlicensed person that has not been delegated by that nurse.

The registered nurse may delegate the RESPONSIBILITY to perform a nursing task to an unlicensed person however the delegating nurse retains the ACCOUNTABILITY for the nursing task.

Please see the Maryland Nurse Practice Act for complete information on Delegation