Issue link: https://nnumagazine.uberflip.com/i/1477982
20 THE TOOLS As rapid changes are implemented in health care settings, RNs are often witnesses to unsafe or compromised patient care conditions. Advocating for safe, therapeutic, and effective care for your patients is one of the most important activities that you as an RN can undertake to protect yourself and your patients. Our contracts provide important tools for protecting patients and your license in these situations. The Professional Practice Committee: The PPC is a direct-care, RN-controlled committee nego- tiated into every contract, with the authority to document unsafe practices and the power to make real changes. Direct-care RNs elect representatives to serve on the committee, which meets in the hospital on paid time. The PPC tracks unsafe conditions through its own inde- pendent documentation system called the Assignment Despite Objection (ADO). The PPC discusses practice and staffing problems on various units by analyzing the ADOs for trends and recurrent issues. The PPC may also elect to report the problem to the appropriate regulatory agencies. The Assignment Despite Objection Form: The ADO gives the RN the ability to report unsafe condi- tions and formally notify management of problems. ADOs are admissible in court, with regulatory agencies, and are protected under federal labor law. It's unlawful for the employer to discipline or retaliate against an RN for filing an ADO. MAJOR NURSING PRACTICE ISSUES X Promotion of the registered nurse as the direct-care provider in all health care settings X Patient advocacy and the nursing process X Empowerment of Professional Practice Committees X Encroachment into nursing practice by other licensed and unlicensed health caregivers X External forces promoting reallocation of nursing functions X Technology and the deskilling of the profession X Deregulation through movement of services from inpatient to outpatient and home settings X Expanded nursing practice issues X Development and monitoring of staffing ratio language X Fragmentation of RN title and work X Occupational health hazards for nurses and violence in the workplace