一位經驗豐富的產科病房註冊護理師因嚴重人力短缺，被強制要求跨科支援 (Float) 至內科加護病房 (MICU)。該 RN 從未在加護病房工作過，她對護理長說：「我對呼吸器和滴定血管收縮劑完全不熟。我拒絕這項分派；我寧可逼卡回家，也不願危害病患安全。」關於該 RN 處置的法律與專業正確性，下列何者正確？
An experienced maternity unit registered nurse (RN) is mandated to float to the Medical Intensive Care Unit (MICU) due to critical short-staffing. The RN has never worked in an ICU and tells the nursing supervisor, "I am totally unfamiliar with ventilators and titrating vasopressors. I refuse this assignment; I will clock out and go home rather than endanger a patient." Which response regarding the RN's action is legally and professionally correct?
- AThe RN should report to the MICU and request to care only for patients whose acuity resembles stable medical-surgical patients.✓ 正解RN 應報到至 MICU，並請求僅照顧病情類似穩定內外科病人的患者。
- BThe nursing supervisor must cancel the float requirement immediately, as cross-specialty floating violates federal labor laws.護理主管必須立即取消跨科支援要求，因為跨專科支援違反聯邦勞工法。
- CThe RN should accept the MICU assignment without complaint but document their lack of experience entirely in the patients' medical records.RN 應無怨言地接受 MICU 的分派，但需在病人病歷中完整記錄其缺乏經驗的事實。
- DThe RN is legally justified in leaving the hospital because accepting an assignment beyond their competence constitutes malpractice.RN 有法律正當性離開醫院，因為接受超出其能力範圍的分派構成醫療過失。
本題探討跨科支援（Floating）與拒絕分派（Refusal of Assignment）的護理法律責任。在美國，醫院要求護士跨科支援是合法的調度方式（不違反勞工法，排除B）。一位 RN 雖然缺乏 ICU 的進階技能，但仍具備生命徵象評估、口服與基礎靜脈給藥等通用的護理能力。如果 RN 直接刷卡下班（拒絕分派並離開現場），將被護理部或州護理局視為病患遺棄（Abandonment）與抗命（Insubordination）（排除D）。正確的專業做法是：RN 必須前往支援單位報到，並主動與該單位的護理長溝通自己的技能限制，要求分配病情相較穩定、不需要進階 ICU 儀器操作（如滴定升壓藥或複雜呼吸器調整）的病患，例如即將轉出的內科病患（選項A正確）。選項C將自己缺乏經驗寫入病患正式病歷中是不專業且引發醫療訴訟風險的行為。
While nurses must comply with floating assignments, they are ethically and legally bound to accept only tasks within their scope of practice and competency. The appropriate action is to report to the unit and request assignments for stable patients that do not require advanced ICU skills, thereby ensuring patient safety without abandoning the facility.
在美國 NCLEX 考試中，Floating 是一大重點，規定 RN 必須報到但只接「能力相符」的穩定病人（例如心衰竭觀察期）。台灣目前也常遇到跨科支援（俗稱阿信），台灣護理學會同樣宣導「不拒絕支援，但有權要求接穩定區病患」，實務觀念吻合。