How Nevada Nurses Can Say “No” to an Unsafe Assignment — Without Risking Their License

Kerry Palakanis
Jul 20
3 min read

As a nurse in Nevada, you have both a professional duty to advocate for patient safety and a right to protect yourself and your license when faced with an unsafe assignment. But saying “no” isn’t easy — especially in the high-pressure environment of healthcare, where short-staffing and unrealistic expectations are all too common.

If you’re ever asked to accept an assignment that you believe puts patients or your license at risk, here’s how you can handle the situation legally, ethically, and effectively.

🚩 What Is an Unsafe Assignment?

An assignment may be considered unsafe if:

You’re being asked to care for more patients than you can safely manage.
You’re assigned patients outside your scope of practice or competency.
Equipment or supplies necessary to provide safe care are missing.
You’re too fatigued, ill, or impaired to perform your duties safely.
The environment poses imminent danger to you or your patients.

Nevada’s Nurse Practice Act (NRS Chapter 632) and the Nevada State Board of Nursing (NSBN) make it clear: your primary obligation is to your patients. Practicing beyond your scope or in a way that endangers patients violates your license.

📋 Steps to Take When Facing an Unsafe Assignment

Here’s how to respond if you’re asked to take on an assignment you believe is unsafe:

1️⃣ Stay Calm & Assess

Take a moment to assess the situation objectively. Is it truly unsafe, or just challenging? Document specific concerns — for example: “I have 10 patients in a critical care unit with no aide support” or “I am being asked to administer medications I am not trained to give.”

2️⃣ Communicate Clearly

Speak to your charge nurse or supervisor as soon as possible. Use “I” statements and focus on patient safety:

✅ “I’m concerned that this assignment is beyond my scope of practice and could jeopardize patient safety.”✅ “I don’t feel competent to safely care for these patients under these conditions.”

Avoid emotional or accusatory language — remain professional and factual.

3️⃣ Offer Alternatives

Show that you’re willing to help within your abilities:

💡 “I can take care of patients within my scope, but I can’t safely take on this additional assignment without jeopardizing care.”

If possible, suggest a reasonable adjustment or solution.

4️⃣ Document Your Objection

If your concerns aren’t addressed, document them in writing. Nevada nurses can use an Assignment Despite Objection (ADO) form or write a formal statement noting:

The date and time of the assignment.
Who made the assignment.
The specific concerns and why you believe it is unsafe.
That you notified your supervisor and the response.

Keep a copy for your records.

5️⃣ Know When to Refuse

If the assignment poses an immediate threat to patient safety or violates the Nurse Practice Act, you have the right — and duty — to refuse. Be sure to:

Clearly state you are refusing the assignment because it would violate your professional duty to provide safe care.
Remain professional and avoid walking out or abandoning your patients.
Continue to care for patients within your capabilities while the situation is being resolved.

⚖️ Your Rights & Responsibilities

The Nevada State Board of Nursing expects nurses to practice within their scope, skill level, and the standards of care. Accepting an assignment you know is unsafe can put your license at risk.

However, refusing assignments in bad faith or abandoning patients without proper notice can also result in disciplinary action. Striking the balance is key.

If you’re unsure, you can contact the Board or your professional association (such as the Nevada Nurses Association) for guidance.

📝 Bottom Line

Saying “no” to an unsafe assignment is not about refusing to help — it’s about protecting your patients and your license. By staying calm, communicating clearly, documenting your concerns, and knowing your rights, you can advocate for safe care and maintain your professionalism.

You’re not just protecting yourself — you’re upholding the integrity of the nursing profession.