Of course you can get fired - for anything.
If you chose not to follow a legitimate prescribers order (Since I am an NP I get both sides of this question) AND do not have full complete justification to back up your actions the prescriber will most likely raise a serious stink with out boss ( I used to manage ER's and ICU's and was unloaded on many times very aggressively by dr's who were really pissed off. Then late as a prescriber I had a few folks buck me and was very unhappy)
Ethicas issues should be sent spline and possibly reviewed by the ethics committe to sound out the issues involved in the incidents to aid everyone in making their decisions comfortably
That said I have had doctors relieved of privileges for totally stupid orders they would not back down from. one ED doc (on night shift of course) ordered 100 mg of demerol and 100 mg seconal IM for a 14 y/o boy with a broken arm being discharged, so he could sleep. (Yes old situation we don't even use those drugs anymore) At the time we had to rely on the PDR for our knowledge and each drug monograph specifically said IN HOSPITAL USE only, and each independently had severe respiratory suppression effects.
I had a discussion with the Doc, who escalated to a very noisy I AM THE DOCTOR, declaration. I advised him No nurse in the department would give the medication combo her ordered. HE demanded the drugs be signed out and handed to him to administered. He did so. He wrote on the chart Give by nnnnMD because PK RN refused. (Can't tell you how ecstatic that he had relieved me of all culpability, if a lawsuit happened, that made me) I put it under the supervisors door telling her to fix this stupidity. Unbeknowns to to me this was the second time that night he had ordered the same combination for a pateint. The LPN that received the order did not question it and gave it and discharged tha patent. The Doc was not around after that.
SO IF you refuse a perfectly legitimate order for unacceptable reasons( UNaccelatable is defined by administration, hospital policy, nursing law, and even Ethics committee) then you are at minimum likely getting disciplined. IF Pateint harm comes from your choice then termination is likely and the hospital is not likely to defend you if a lawsuit occurs.
BTW the role of an ethics committee is not to make a decision or deem anyone right to wrong but to air all the issues from all participants, bring in standard ethical principles and assist in developing a consensus for action. Ethics committees do not dictate actions.
If you are correct that the action is wrong for moral, ethics, legal, or common sense reasons AND you can back up your refusals your nursing leadership should back you up.
And sometimes if you buck a doctor who is making the hospital tons of money you will not win no matter how perfectly absolutely correct you are because even today, or especially today post pandemic, BIG money talk very loudly.
Good luck.
