This is a loaded question and one that we receive regularly on our TNA Practice Hotline. The worst situation for a nurse is to need answers to a question and not have a resource. While the following answer will not be able to encompass everything you need to know about how to invoke SHNPR, here are a few tips to get started. To qualify for the SHNPR, your organization must employ or contract for services a minimum of 8 nurses, 4 of whom are RNs [Tex. Occ. Code §303.0015; Tex. Admin. Code §§217.19(c) and 217.20(c)].

Know your policy. This is not something you want to be looking up for the first time when invoking safe harbor. It’s essential to familiarize yourself with your organization’s policies and procedures ahead of time. The Chief Nursing Officer (CNO), or any nurse holding any title who is responsible for overseeing nursing services, has a duty to ensure a clear policy is in place and that all nurses are educated about the process and able to access it when needed.

Notify your supervisor. You will need to notify your supervisor in writing that you are invoking safe harbor. If you are engaged in patient care and are unable to complete the request in writing, you have the right to invoke safe harbor verbally to your supervisor. The goal of notifying your supervisor is to collaborate before needing to move forward with the safe harbor request. If collaboration with your supervisor is not a feasible option, you should then continue with your invocation.

Complete the quick request form. This is a short form giving the basic information needed to identify the rationale for invoking safe harbor. The notification to your supervisor must meet the requests established by the Texas Board of Nursing (BON) to include at minimum the content in the Quick Request form. Your employer may have their own internal form they use. Sometimes your supervisor can mitigate or resolve the assignment, but it is the nurse’s choice to move forward with the request. Additionally, it includes date, time, name of nurse invoking safe harbor, name of supervisor, location of assignment, and a brief explanation of why you are invoking safe harbor.

Complete the comprehensive request form. Before clocking out and leaving your assignment, make sure to complete the longer, comprehensive request form. Your employer may have their own form, or you can use the BON form. This form may seem repetitive, but it is important you complete it in its entirety with as much information as possible. This form will be used during the peer review committee meeting.

Plan for the peer review committee meeting. One of the biggest misconceptions of SHNPR is that the forms are sent directly to the BON. In fact, most nurses have no idea where these forms go. The forms are intended to be internal documents managed by the NPR Committee. Within 14 days after invoking safe harbor, you should be invited to attend the NPR Committee meeting where a group of your peers (not supervisors) discuss the circumstances surrounding your assignment to make a determination. This should be a collegial process focused on the facts surrounding your assignment.

Every organization may have their own procedures in place. If you are unsure of what to do, you can always call the TNA Practice hotline by calling 1.800.862.2022, ext.132 for help or attend an NPR workshop. There are several nuances to the NPR law that cannot be covered in one short, written response. TN