Nurses can refuse to treat if they lack PPE, and we will support them – RCN

College issues guidance on the decision of last resort during COVID-19 pandemic

Nurses who do not have adequate personal protective equipment (PPE) can refuse, as a last resort, to treat patients, the RCN said.

The college stresses in new guidance that while refusal to treat during the COVID-19 pandemic would 'go against every instinct' for nursing staff, their safety must not be compromised.

Is your PPE adequate, and what to do if it isn’t

The guidance sets out the process RCN members should follow to assess whether the PPE provided is appropriate, and what to do if it is not.

If members have exhausted all other measures to reduce risk and they have not been given appropriate PPE in line with the UK infection prevention and control guidance, they are entitled to refuse to work, the guidance states.

'This will be a last resort and the RCN recognises what a difficult step this would be for nursing staff,' the document adds.

It points out that nurses are not simply taking their own well-being into account, especially if they are themselves vulnerable: they might also spread infection to others, and would not be available to provide care. They could be putting their own family at risk too.

Majority of nurses in survey report lack of proper PPE

The new guidance comes as a Nursing Standard survey of almost 3,500 UK nursing staff, of whom two thirds said they did not have adequate PPE.

One third of respondents had paid for PPE themselves, while one in 10 had resorted to making their own.

The RCN guidance also raises the issue of potential legal consequences for a nurse who takes a decision to refuse treatment that is later criticised, or results in dismissal or litigation for clinical negligence.

‘Safety of nursing staff must not be compromised’

But the college maintains members who take this decision and are later criticised will be provided with legal representation and other support through any proceedings, without judgement.

An RCN spokesperson said: 'For nursing staff, this will go against every instinct. But their safety must not be compromised.

'We offer support and guidance on the steps nursing staff can take before coming to that judgement.

'Nursing staff are extremely determined and the public can be reassured by that.'

View our COVID-19 resource centre

Further information

RCN refusal to treat guidance

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