Using the title nurse binds you ethically to your patient. Showing up to work means you have a duty to care for patients. You cannot walk into a facility and walk out because you don’t feel the assignment is fair. You protect yourself through documentation whether it be on the chart or your own anecdotal notes. To put into prospective; what if your child were a patient and a nurse walked out because they thought their assignment was unfair and just walked out? The clock does not determine a nurse’s ethical obligation. Most facilities have a call off policy and if a nurse reports to duty whether they clock in or not obligates them. In litigation the facility will certainly use this fact. Too many times I hear nurses complain about assignments and have yet to even see the patient to evaluate if the assignment is truly as complicated as it seems. Many nurse have said I can have 2 patients that make my day a nightmare but have 6 and have a great day.