My employer recently introduced a ‘Code Silver’ policy in my organization, which directs employees to run, hide and survive when there is a combative individual with a lethal weapon on the premises. Do I have the right to refuse to provide care to clients in hazardous situations, where the hazard is workplace violence?

This depends on the context and factors surrounding a particular practice situation. Under the Nursing Act, 1991, it is considered professional misconduct to discontinue professional services that a client needs, unless:

• the client requests the discontinuation

• alternative or replacement services are arranged, or

• the client is given reasonable opportunity to arrange alternative or replacement services

However, in emergencies, such as a ‘Code Red’ response to fire, the College does not expect nurses to put their lives or personal safety at risk when caring for clients.

Refusing to work during an emergency situation that places a nurse’s life in danger is not the type of situation that was intended by the “discontinuation of services” in the Nursing Act.

Under the Occupational Health and Safety Act, employers are also accountable for establishing a safe work environment and minimizing real or potential risks to employees and clients alike. The College encourages nurses to work collaboratively with their employers to appreciate real or potential threats, review relevant organizational policies, and if needed, develop policies and guidelines that are specific to the practice setting and driven by client interests and safety.

For more information on maintaining a quality practice setting and guidelines for decision-making, read Refusing Assignments and Discontinuing Nursing Services and Code of Conduct.