Abandonment: What It Is And Is Not
Over the years I have seen and heard many nurse leaders threaten to report nurses for patient abandonment. State boards of nursing report receiving a lot of abandonment complaints each year, many of which are not true abandonment cases. There are probably several reasons why this issue comes up as much as it does. The fact that boards reject a significant number of complaints suggests there is confusion about what constitutes patient abandonment. In this post, I will tell you what it is — and what it isn’t – in the professional context.
The average person intuitively thinks of abandonment as leaving with no intention of returning and no intention of fulfilling obligations. Medical and legal definitions refer to a doctor abandoning a patient as: “unilateral severance” or “negligent termination” of a professional relationship with a patient without notice, the patient’s consent, or providing a competent replacement, while the patient still needs care. The military concept of desertion is analogous, where someone leaves their duty station without permission or just cause, possibly putting others in danger.
Those boards of nursing that have issued a position or opinion statement on abandonment have adopted almost identical language. For a situation to constitute patient abandonment, two things must have happened: 1) the nurse must have accepted the assignment, which establishes a nurse-patient relationship, and 2) severed the relationship without notice to an appropriate person (supervisor, manager, etc.) so that another nurse can continue to provide care to the patient(s).
The issue that boards of nursing run into is the distinction between patient abandonment and employment abandonment. Many complaints (and threats to report) are employment issues. These are distinct from unprofessional or unsafe conduct while caring for patients.
Both the nurse leader and the caregiver have legal duties in this area. Nurses caring for patients have a duty to provide safe, knowledgeable, competent, skilled care. They also have a duty to delegate care tasks to appropriate personnel. Bottom line: once a nurse accepts an assignment or agrees to care for a patient, he or she must complete the assignment or finish the care with a safe and competent handoff, unless there are extraordinary circumstances (think caregiver’s sudden illness, a natural disaster, active shooter.)
Nurse leaders also have legal duties. First, a leader has the duty to assess and know the capabilities of each of the staff members who are available to assume duties in that area, particularly as those capabilities relate to the needs of each patient. Leaders have a duty to appropriately assign staff members so that each patient has necessary care provided by a competent and skilled caregiver. Leaders also have an obligation, when considering staff assignments and delegation of duties, to evaluate factors such as fatigue, lack of orientation to the unit, the level of knowledge or experience a nurse has, and any other factors that affect a nurse’s ability to provide safe care.
Boards of nursing can investigate and discipline both nurses and leaders who breach these duties. Nurses who accept an assignment knowing they lack competency or that the assignment is beyond their scope of practice put patients at risk. Leaders who know (or reasonably should know) that an assignment is improper can also be disciplined. If, in a worst-case scenario, a patient is harmed, the caregiver, leader and facility could be sued for negligent supervision or delegation of duties, among other claims. The standard is always to provide safe, knowledgeable and skilled care by the best available staff.
What is patient abandonment and what isn’t? Here are the most common behaviors cited as abandonment by boards of nursing followed by those that are not.
Examples of abandonment:
- Accepting the assignment and then leaving the unit without notifying a qualified person
- Leaving without reporting to the on-coming shift
- Leaving patients without any licensed supervision (especially at a long- term care facility with no licensed person coming on
duty) - Sleeping on duty
- Going off the unit without notifying a qualified person and arranging coverage of your patients
- Leaving in an emergency situation
- Overlooking or failing to report abuse or neglect
- Giving care while impaired
- Giving incompetent care
- Delegating care to an unqualified caregiver
- Failure to perform assigned responsibilities
The following behaviors are not patient abandonment but they are employment issues which can lead to facility or organization action, even though the board of nursing refuses to get involved:
- Failing to call in, not showing up, or arriving late for a shift
- Refusing an assignment for religious, cultural, legal or ethical reasons
- Refusing to work in an unsafe situation
- Refusing to give care that may harm the patient
- Refusing to delegate patient care to an unsafe caregiver
- Refusing to work mandatory overtime
- Not returning from a leave of absence
- Ending employment without sufficient notice for the employer to find a replacement
- Refusing to work all remaining scheduled shifts after resigning
- Refusing to work in an unfamiliar, specialized, or other type of area when you have had no orientation, education or experience in the area – such as refusing to float to an unfamiliar unit
- Refusing to come in and cover a shift
- Giving notice and working only part of the remaining time
Leaders: know the difference between patient abandonment and an employment issue. Listen and respect your staff members when they voice concerns. Know your staff members and delegate appropriately. Insist on qualified help when needed. Try to work with both your senior leadership and your staff members as much as possible and document the situation.
Nurses: know the difference between patient abandonment and an employment issue. Do not accept an assignment that you are unqualified to handle, whether it is because you are exhausted or haven’t been oriented or educated to the area. Once you accept an assignment, you have a duty to provide safe, competent care until you properly hand off care to another licensed provider. Ask for help. Document carefully. Be objective and professional when you decline an assignment. You do not have to give detailed reasons for refusing but you should understand what you can and cannot do.
I work for a company called Action Urgent care. It functions as a minute clinic, where there is only on person on site- the LVN. Who manage every aspect it takes to run the clinic and the doctors are over video chat. This company is very poorly managed. The make and change the nurses schedules without notice. They do not uphold the contracts they’ve promised at hire, with bonus pay. It’s extremely any help with anything because you never see a single coworker in person. So one day I came in to work and found they hired a new person and gave her my shift without notice. They gave her the only two I work out of that week and said I would continue working next week. I got fed and quit that day that I was not working. Is this abandonment? My supervisor is threatening to report this.
I just found your comment. It sounds as though you were in a horrible position. The short answer is that quitting when you aren’t working is not abandonment. Supervisors love to threaten when they are faced with a position to fill but, as my article said, state boards and the ANA specifically define abandonment as having taken responsibility for a patient and then leaving without arranging coverage/care or giving notice to the person in charge. I hope this helps and that you didn’t get flack from the board.
I was just asked to work the Covid unit and I refuse I just left the job and she called and said She gonna file abandonment issues on my license I work in South Carolina it’s not my permanent job I work through a mobile app
If you accepted an assignment of patients (as in the person in charge said, “you have these patients” and you said, “OK” and started working), and then changed your mind, walked out, etc., that is abandonment.
If you arrived for the shift and the person in charge said, “report to the COVID unit,” and you said “no” and then left, that is not abandonment. That is an employment issue and your company may discipline you for refusing an assignment, but under the usual state boards of nursing definitions — barring something recently issued by your state’s BON that says otherwise, you didn’t abandon patients assigned to you. You refused the assignment and never started caring for the patients.
As a CNA, Is it considered abandonment or is it illegal to refuse to work on a hall by yourself with more than 20 residents due to the fact your coworker that was also assigned with you, calls out? Is it then up to management to find and or get help
First of all, document for yourself everything that has happened. If you have texts, keep them. Note names, dates, times, locations, conditions, who said what, etc. Keep it factual. Keep the memo/record in a safe place. Do this now while everything is fresh.
Second, I don’t know South Carolina’s laws or regulations. Abandonment claims are usually directed at RNs, as the licensed caregiver and the person in charge of the patient’s care. CNAs could be accused of abandoning patients if they started work, the RN delegated tasks, and the CNA left without notice after starting work.
What I’m seeing here is that you refused the assignment and left before starting to work with patients. If that is what happened, that is not abandonment. It is an employment issue, and you may not be asked back, but you didn’t start taking care of patients and then leave. Your company that sends you the notice of work and pays you may take a dim view of your leaving but that is an employment issue, most likely not something the state would get involved with.
And yes, the facility has the responsibility to staff adequately and at safe levels. There are state and federal requirements for this. These days, with the shortage of qualified caregivers, it is very hard to staff as needed, and very frustrating for both the facility leaders and the caregivers themselves.
So again, be sure to document carefully what happened. If you have a parent employer/company, contact human resources and let them know what happened.
I’ve chosen to resign from agency nursing, gave 30 day notice, I’ve had several call outs due to personal illness and family emergencies as well death in family, so my attendance hasnt been the best. There are other issues related to unsafe, understaffed, unsafe nurse to patients ratio, have I given proper notice? Email & texted Resignation to all supervisors, can you advise if this is acceptable way to resign, etc ty!
Yes, this should be ample notice. Also notify HR directly to ensure they have the same notice you sent your supervisors. Ask how you turn in your badge or any other facility property you might have been issued to perform your job and if they need any forms completed for tax purposes, etc.
Hello there, I’ve been a nurse for 7 years now. Just recently I quit a correctional job without giving a notice. I went to work one morning, went to my post, seen what a mess it was, things that were left over from the day shift before me and I knew there was not enough time on my shift to complete everything I normally do plus the extra work that was leftover so I just left. There were two nurses there from night shift still charting their medications they gave all while complaining about what a night they had. I never took report from the night shift nurses, I did not take the keys to the medication cart, nor did I count the medication cart (such as narcotics, sharps, etc.). Now this facility said they were going to report me to the BON for abandonment. At first my agency said the facility was going to report me for “insubordination” but now they’re using the word “abandonment.” I know it was wrong on my part to just leave without talking to a supervisor first but I was overwhelmed and felt unsafe within my scope of practice to stay in that situation. I just think that it is very unfair that they are calling it abandonment. There were plenty of qualified professionals there to care for the offenders and I did not jeopardize the safety of anyone. Please provide any feedback anyone has. Thank you.
I just found your comment and apologize for not answering sooner. Based on what you said here, I think your board would likely reprimand you but I would hope they didn’t do anything more. Yes, talking with a supervisor first is important. While only Texas has what is called a “safe harbor provision” that allows nurses to formally protest an unsafe assignment, ANY nurse can and should notify the chain of command that they are not comfortable with the assignment because it is unsafe, jeopardizes patients and could jeopardize your license. It is up to the supervisor to then do whatever s/he can to remedy the situation. Document everything including the circumstances, who you told, what was said, etc. Quitting before taking the assignment is not abandonment by legal definition, but it doesn’t reflect well on you as a professional. On the other hand, if you had suddenly become ill or had a personal emergency and had to leave, they couldn’t call that abandonment either.
I left a job assignment in the middle of my shift due to it being a hostile environment as well as out right insubordination and disrespect by a health tech . I was not the only licensed staff on the unit and I reported to my direct Charge nurse that I was leaving ., There were 3 of us licensed nurses on that unit ,
Based on what you submitted (looks like you stopped in mid-sentence), you skated very, very close to the line here. Insubordination and disrespect from a tech is a problem best handled with the help of the charge nurse and ultimately the chain of command. Your focus is on care and safety of the patients, not the tech’s behavior. “Hostile work environment” could be anything. The question is whether you or your patients were in immediate danger. If not, then again, the way to handle this is through the chain of command and the HR department. Careful documentation on your part would support your claims. You say you reported to the charge nurse but leaving mid-shift put the charge nurse, the other nurses, and the patients in a bad situation. Had you had an emergency (personal illness, family crisis, etc.) that would justify leaving. If someone was threatening you or your patients with physical harm, you could have called security or even the local police, depending on the gravity of the threats. Please document for your own files exactly who, what, when, where, etc. with exact quotes as much as possible. Contact HR. Refuse future assignments if necessary, but if the problem is mean co-workers, family, or patients, the answer is seldom to walk out mid-shift. Quit at the end of the shift if need be. I recommend Vital Smarts’ book, Crucial Conversations, for help to improve assertive communication skills and techniques to deal with difficult situations. Not knowing exactly what happened, I can’t be more specific but I would also encourage you to call your state board of nursing and discuss the incident with them. Your state nurses’ association can also give you some resources to deal constructively with the problem. Good luck!
You did!! At your shift you’re in charge of those patients as soon as you clock in to the time you clock out. Just think of it this way if you had to babysit a child and once you get there notice that the house is a mess the child hasn’t been changed hasn’t been fed or nothing but the parent is still there trying to get ready to leave and you notice that everything is not in order for your day to start you can’t just get up and walk out regardless if the parent was still there or the nurse prior from the morning was still there . that’s abandoning the child and your patience
I am a hospice nurse in Florida. I gave my 2wk notice. I had 3 days of my notice left to work. I am throughly disgusted with my department. We are responsible to drive anywhere in the county the schedulers want to send us. There is alot of clicks for which I refuse to be a part of and favortism. For the last 3 shifts Ive worked they had me go 225miles round trip for all 3 shifts when there were shifts much closer to my home. So this morning I got cancelled at quarter till 6 because my patient passed away during the night and at 7:15 the rude scheduler called me and told me she had a case for me to open which was 38 miles one way. I told her no I’m not going I’m done driving and I quit. I did not go to the patient’s house or accept the assignment or start working with the patient this was all on the phone when I found out on the computer where the patient lived I called back and told her no I’m not going I’m tired of driving and I quit. Now the manager is accusing me of job abandoment and states”I will be checking for other consequences. What consequences..I quit. I didnt work out my 2 weeks and I was not with a patient and walked out on them. Besides not being rehired at this company in the future, what other consequences would there be? Florida is an at will state.
I just found your comment and apologize for not answering sooner. Florida follows the definition of abandonment that other states use. If you haven’t accepted an assignment and aren’t already caring for a patient, you haven’t abandoned them. You were nearing the end of your 2-week notice period. Was it professional to quit sooner? Maybe not. Did you abandon the patient? No. Be careful about how you paint your experiences with the company and why you left when you interview with others but if I were on the BON and saw this, I wouldn’t call it abandonment, especially when there were other nurses in the vicinity to handle the case.
Leaving in an emergency – such as an active shooter, or a hurricane hitting the hospital, is not abandonment. If you’re preserving your life you are not guilty of abandonment.
I’m going to disagree with you on this one. Assuming you are working your shift and have been caring for your patients, you have to follow hospital procedures. In an active shooter situation, you are not abandoning the patient when you take cover, barricade doors, etc. You ARE abandoning them if you leave the hospital, don’t tell anyone, and don’t arrange continuing care for your patients.
In a hurricane, the hospital will have an evacuation procedure and all staff members, including nurses, are needed to carry it out. Again, leaving the hospital without ensuring that your patients are cared for and safe is definitely abandonment.
If you have some specific circumstances that make the situation different, I’d still refer you to your hospital’s procedures and tell you talk to your supervisor — go up the chain of command if you have to — but don’t just leave.
I have to say that in the midst of an acute active shooter situation, each of which is unique, all of which are extremely stressful, you will not be in occupational or professional jeopardy if you do whatever to try to save your life. This might include distancing yourself from a vulnerable patient. Active shooter education in MA hospitals specifically states this. To me, this makes sense. You can’t put workers in double jeopardy, having to worry about losing job or license in the moments when they are worrying about losing their life. It fits perfectly with what some philosopher said during WW2: “Heroism is something that cannot be compelled.” Of course if at all possible under these conditions you try to arrange for continuing care for your patients. But I can imagine that some persons might be so acutely traumatized they simply walk out.
First, let’s hope that active shooter situations don’t become an issue for anyone. Second, you follow your facility’s protocol during ANY dangerous situation, whether it is an active shooter, a fire, a natural disaster, or something else. The last thing anyone in a dangerous situation should be worrying about is what the BON will say afterward. We train, we prepare, and we do the best that we can under the circumstances. No one, least of all the BON, expects you to put yourself in harm’s way.
Agreed.
Worked for nurse finders , showed up to a job after sitting for nearly an hr the nurse gave me a crappy report , never showed me where the AED was , asked me to sign a packet stating i was oriented to the facility , I said I have to get something in my car , called nurse finders and told them it was unsafe and I wouldn’t risk my license . I never took count . A month later They have reported me to the Bon in ma . Should I be worried ? I never took the keys and I called the agency right away , they told me I had to go back or I would lose my license . I refused .
Just now seeing your question. Be sure you document everything about the situation, who you talked to, when, who said what, etc. In the future, if you are faced with an unsafe assignment, make an official report up the chain (as you did), tell them it is against state and national nursing standards of practice to accept an unsafe assignment and that you will file a written statement with the BON. Ask them what they can do to help make the situation safer now and in the future. Be polite, but be firm. Don’t argue back. Just keep asking what can they do to make the situation safer right now?
In this case, based on what you’ve reported here, you didn’t take the assignment so you didn’t meet the legal definition of abandonment. While a board might frown on you quitting at the start of the shift, as long as you can show unsafe conditions, you should be fine. Contact your malpractice insurance carrier for legal support if the board does issue a complaint.
Hello, I was working for an in home care agency, in PA as a caregiver. They wanted me to travel over 40 miles to my new client. Compared to the client I had a two weeks before that lived 5 mins away from me. They knew I didn’t want to drive that far, as it wasn’t worth my pay. However, this was my first shift with this client. & there was someone there to train me anyways. So, the patient wasn’t alone & I do have record of them saying it was a training day at the clients house, & so & so was waiting for me.. but now they are bringing up abandonment. Cause I was a no call/no show bc they knew I didn’t want to travel the distance.. but kept saying there will be a shift increase due to the distance. I don’t believe this is abandonment just bc there was still a caregiver there with the consumer..
This is an employment issue, not a case of abandonment. Can your employer discipline you for not going to the assignment? Yes. Would the BON consider it patient abandonment? Unlikely because it does not fit the legal definition. You have a communication problem with your employer. Your employer expects you, as part of the job requirements, to drive to wherever the assignment is. Supposedly they will either increase your pay to cover the additional time and costs or reimburse you for the mileage. As for whether you can set conditions on the terms of your employment, that is between you and the agency. If you put limitations in writing when you joined the company, and the company accepted those limitations, you might have a legitimate grievance and should talk to an employment attorney if you’ve suffered any negative consequences. Otherwise, you may want to consult a Pennsylvania attorney regarding your rights for an “implied” or “oral” contract. I don’t know Pennsylvania law and cannot advise you as to whether oral limitations are allowed in employment settings. Good luck!
Im a cna schedule 2/10 is it considered abandonedment if i leave. At 10 before my relieve arrives. And am i obligated to work extra hour .
You are not an RN so Board of Nursing regulations probably wouldn’t apply to you. However, every healthcare worker has an obligation to continuing caring for their patients until someone else has assumed responsibility. While you may not have a duty under a nurse practice act, you do have one as an employee of the facility. Talk to your supervisor if you have to leave on time for some reason or if this happens frequently. Don’t leave unless someone has agreed to care for your patients.
I’m a CNA. I work 2nd shift at a long term care facility in TN. We’ve had a lot of aids quit on all shifts which has left us short handed. A nurse tells me and my co worker last night that one of us has to stay because their was only one aid that came to work. There are 62 patients on the hall and there was two LPN’s and one aid in my hall. We have 189 beds in the facility. I’m not sure how many other aids where in the building but there were 6 LPN’s and one RN in the building. Our facility isn’t full with residents. My question is, can an aid be made to stay if another aid calls in? Remember, there was two LPNs and one aid on my hall. Company policy doesn’t state that it’s mandatory overtime if call ins happen. I feel like we are being harassed and they are trying to scare us. Please advice. Thank you
This is an employment law question and it is one I’m hearing more frequently these days. You ask if you can be forced to stay over when another CNA calls in. The short answer is that your employer cannot FORCE you to do anything. Will your employer take action against you if you don’t? Possibly, and that’s something you have to weigh when you are deciding whether to stay or go home. As long as there is no disaster or other emergency where all hands are needed, and as long as there are licensed personnel present, if you respectfully decline to stay over, that’s your call. The facility sounds as though it has problems and is unable to keep a stable staff. This is a separate issue that you may want to think about — whether you want to continue to work there in view of the problems or can you work with administration to find solutions to the problems? If you feel threatened or unsafe, I advise talking to the LTC licensing board in Nashville or to an attorney who has experience in employment law so that you can know your options.
a nurse was two hours into her shift on an Alzheimer’s unit, left a note that she quit and the med keys on the nurses station, and walked out. there was another nurse on another unit.
If you are asking whether this is abandonment, some attorneys would say this is an employment issue. Others would call it abandonment with a side of employment. From a professional nursing perspective, the nurse apparently did not give report, did not notify anyone that she/he was going to leave, and didn’t arrange for someone to take care of her/his assigned patients. That is abandonment. Leaving a note and the keys, even if there is someone else on the unit qualified to care for the patients, is unprofessional and puts patients at risk of harm. Waiting until the end of the shift, after handing off care and responsibility, would have been the responsible, professional thing to do. There is no indication that there were any other extenuating circumstances, such as personal illness, that would impact the situation. This left the unit short staffed, the remaining staff caught off-guard and overloaded, with patients very probably not getting the care they needed at the least, and with the potential for injury or worse. Unprofessional conduct.
I am a nurse working 8 hour night shifts in a facility on a unit that has 30 patients; I am the only nurse. I usually have two support staff sometimes three. One patient is very challenging to work with because of very poor ADLs related to an ostomy. The patient has a treatment plan in place. The staff on third shift are following the treatment plan checking the appliance regularly and encouraging/assisting with good hygiene practices while I also assist with stoma care/appliance changes. The patient sleeps on night shift unless third shift staff wakes the patient up. According to the patient’s treatment plan, at 0700 (day shift) the patient is to shower, clean room, attend to ADLs. Last night I personally changed the appliance on two separate occasions with the last change occurring at 0530. At 0630 while I was giving report to the incoming nurse and day shift staff, a day shift staffer abruptly came in stating the patient was “completely dirty.” I know that third shift staff is doing their job. I know that at 0530 the patient was clean. Everything is documented. It should be noted that patient also has a history of personally causing the ostomy appliance to malfunction. The incoming nurse is a regular employee who is specifically assigned to this unit. The incoming nurse proceeds to basically tell me that the patient needs to be “clean” and night shift needs to do it before going home. I attempt to explain to the incoming nurse that night shift can’t necessarily prevent the patient from getting dirty just prior to shift change. I explain that night shift is following the treatment plan and at 0530 the patient was clean. I add that no one is trying to “not do their job” and push things off to the next shift. I feel like we do what we can on our shift and whatever cannot get done is passed off to the next shift no matter which shift it is. The incoming nurse then tells me that due to “health” reasons the patient cannot be dirty out on the unit and therefore the incoming nurse will not accept hand-off report from me on this specific patient until the patient is totally cleaned up. The incoming nurse then states that third shift staff should get patient up earlier and showered before day shift arrives (which is not suppose to occur until after third shift leaves according to the treatment plan). The patient’s hygiene/ADL issues are long-standing (years) that the incoming nurse is quite familiar with. Has the incoming nurse abandoned her patient? Employment abandonment? Both? The incoming nurse has accepted the assignment working for this facility on this specific unit but refuses to provide care to this one particular patient for “health reasons” on this particular day until someone else cleans the patient up.
This definitely sounds like something you should address with the nursing supervisor or director. The on-coming shift may not like that a patient has soiled themselves but they can’t make the departing shift stick around to continue caring for the patient and they don’t have the authority to unilaterally change the care plan. I don’t know whether this would qualify as abandonment per se but she/he is trying to refuse the assignment unless certain conditions of his/her making are met, in effect she/he is trying to hold you over. Most of us have, at some time or another, rounded on patients at the start of a shift and found one who needed cleaning up. You just do it as part of good patient care. Talk with your director and ask how you should handle this.
I am a nurse working through agency at a facility an hour after I got to work a nurse came and said the supervisor wants you to move to pathways which is in a building you have to drive to, we counted I gave her report then I drove to this building the doors were locked and and I didn’t have an employee badge because I am agency, I used my cell phone and called the facility the security guard answered and said he would send someone down I waited for 15mins standing at the door at 12am no one shows so I go back to my car and I call again no one answers so 30mins later I call the agency and tell them what happened and express that I’m going to go home if no one comes to the door, she tells me she will call back and I’m waiting another 10mins after trying to go back to the other doors and then being locked too I leave the facility the agency then calls me back saying the supervisor was going to come let me in by this time I tell her I left as that I quit, I was nervous and kind of scared to be out in a parking lot that late, they say this could be an abandonment, is this true?
I recommend calling your board of nursing and talking to an advisor there, just to put them on notice about the facility. The facts of this situation are that you started a shift and then were reassigned to another building. You handed over your current patients and duties and spent an hour trying to get access to the building, making phone calls and repeated attempts to find an open door or someone who could let you in. You weren’t assigned to any patients and so this is not patient abandonment. Is it employment abandonment? A good lawyer would say no because you acted in good faith after repeated attempts to comply with directions. While you have an obligation to patients, you also have the right to exercise safety for yourself. It would be different if you’d only knocked once, didn’t call anyone, and left but that’s not what happened. Notify the BON and then talk with the agency and ask them what else you reasonably could have done (spend the night in the parking lot? No.)
Hello ma’am,
I am an Occupational Health RN case manager. I work in a plant that gives no support and the management has made this a very hostile work environment. I sought help through EAP, have be one symptomatic with elevated Blood Pressure readings ( I never have been diagnosed with HTN, my normal pressure readings are 100-118/60-70s). I plan to leave immediately without notice, I dont give direct patient care, but do the FMLA, Short-term disability pay, and worker’s compensation. I attend to occupational illnesses and injuries. Can my employer report my not giving notice as patient abandonment?
Quitting under the circumstances you describe is not abandonment. Is it unprofessional conduct? That’s a different question. Boards tend to shy away from employment matters. If you are worried about any kind of report to the BON, I recommend calling the board and talking with someone there to feel out their take on what constitutes unprofessional conduct. Preserving your health in a hostile work environment sounds like a pretty good reason to leave though.
I reported to a scheduled shift and was told by the charge nurse when entering the unit that I would have to give report to another RN that was called back in to work (she was placed on what’s called a “low census” day until it was determined that “she” was needed) when she arrived around 7:30pm and then I would float to another unit. She started the xo versatile with “I am so sorry”. I voiced my concern with the decision and also my disagreement with it based on the fact that I was the last nurse to float there. She then attempted to verify my statement and followed it by, “well it doesn’t matter because our policy is that the nurse with the least seniority floats twice consecutively within the quarter”. I then expressed the fact that there were two least senior nurses on the unit other than me, and also that I saw my name where I was already assigned to the patients on my unit and someone came in behind her and re-arranged the assignment list (which is often done to cater to the more senior nurses who dislike floating or taking care of certain patients on the unit). I made it clear to my charge nurse at the time that the float was unfair. The nurses who were present had not been oriented to the other unit; however, the patient assignment on the other unit was within the scope of practice and level of care for any and all licensed RNs on our unit to care for. I was once again, being manipulated into taking an unfair assignment based by means of indirect discrimination. I expressed my concerns and also told the charge nurse whom was the most superior professional present at that time, that I was not going to accept the floating assignment. She then said, “the next time write it in this book and once you float for two consecutive days you will no longer have to within this quarter”. So she blatantly ignored my concerns and disagreement. I went on to scrub in on the unit and received report from the nurses for whom patients were assigned to me. After receiving report, I started to care for my assigned patients on my unit until the other nurse arrived from home. The nurse arrived to the unit about 7:40pm. At that time, I gave hand-off report to her on the infant’s I assumed care for. I then washed my hands, grabbed my bag, walked off of my unit, got into my car and went home. So I decided to quit my job not only for this one instance, but repeated instances that led up to this moment. I refused to float and did not give a sufficient notice to my employer, which I agree it’s very unprofessional. However, my supervisor and manager contacted me via phone that night and following day and voiced concerns saying they wanted to make sure I was okay. I refused to respond without legal counsel first. I received a message from my supervisor threatening to report me to the board of nursing for my behavior that night which would “jeopardize my nursing license”. My behavior was polite, non-violent, and professional, as always during the entire discussion with my charge nurse and during hand off report. I have witnesses but aren’t sure they’ll vouch for me given the circumstances and the retaliation they could receive from the facility. I never accepted another assignment, which means I never abandoned my patients. Although, not as professional as I wanted to be I had no intentions of this happening. Is this in any way a violation of the Nurse Practice Act or could I face any problems with the BON in the state of S.C.?
I’m not licensed in South Carolina and I can’t give you legal advice. I can say that, based on the definition of patient abandonment, your attorney there should be able to successfully argue that this is an employment issue, not a patient abandonment issue. You’ve acknowledged that it wasn’t the most professional way to quit but since you had no assigned patients and had made it clear you weren’t going to float, it comes back to employment concerns. If you haven’t already, I recommend finding an attorney in your state who can advocate for you. If the facility does file a complaint with the BON, they will first have to investigate and should talk to you before deciding whether or not to consider disciplinary action. It won’t happen overnight. If you have your own malpractice policy outside work, call them and see if they can connect you with an attorney who knows how to handle professional board complaints or check with TAANA (The American Association of Nurse Attorneys) to see if they have anyone in your state. Good luck!
I quit my job after refusing to float to another unit. I did not have a patient assignment nor did I ever pick up the patient assignment on the other unit. I walked out and never returned. My job is turning me into the BON. Can they do this? And, for what violation?
I’m sorry you’re having this problem. Employers can file complaints with the BON but under the limited circumstances you’ve given, I would doubt the board would take any action. The first thing a board does upon receiving a complaint is to investigate it. You may get a certified letter or a phone call from someone assigned by the board to conduct investigations. The board is concerned about patient safety and the professional appearance of nurses to the public, not employment disputes. Once the investigation report is complete, the board decides whether to pursue disciplinary action and on what grounds. They have to let you know in writing and give you an opportunity to respond. Most boards would kick this back to the employer but it depends on the initial investigation results. You may want to talk with an attorney (preferably an RN/JD) who knows how to handle professional board complaints just so you’ll have someone to call in case the board decides to take the complaint further. (See the answer to the previous post for suggestions on that.) Good luck!
I work 12 hour night shifts in an assisted living facility in ohio which is currently short staffed and is also in between DON’s at the moment. With other nurses there have been situations where there is no relief and the executive director threatens abandonment if we do not stay to cover the shift. I know that ohio is still in the process of passing a law that prevents forced overtime but do I have any other options to prevent being forced to stay and work? What if I fo not feel safe to work the shift due to night shift fatigue?
You are definitely between a rock and a hard place here. You actually ask about two problems here. The first is whether the director can force you to stay over and complain to the BON about abandonment if you don’t. The second is about being unsafe to work.
The first thing I recommend that you do is to keep a written log of all information about these situations — what happens, when, who you talked to, what was said (in quotes, if possible), etc. The second thing is to make a couple of phone calls. First, contact your state nurses’ association and talk with someone there about the situation. Even if you are not a member, they can talk with you about the status of any changes in the law, whether Ohio nurses have a “safe harbor” provision, and what they recommend you do. Also ask them if they can recommend any attorneys who have worked with nurses on employment issues.
Third, call and talk to an attorney who specializes in employment law. At least do an initial consultation — if you aren’t happy or don’t connect with the first one you talk with, try another. You don’t necessarily need to retain the lawyer just yet, but it is helpful to talk with one about your options under Ohio law.
Last, if you don’t already have your own malpractice insurance policy, get one. STAT. There are several companies that cover nurses — the state nurses’ association can give you names — and the premium is quite reasonable. (See my post on professional liability insurance.) This will give you a safety net and your own lawyer if something happens, either while you’re working or if the director files a BON complaint.
I wish I had better solutions for you today but these steps are the best you can take right now to protect yourself, your patients, and your license. Good luck!
Florida. The hospital system I work for is cracking down on overtime. (which 90 % of us would rather not do anyway). Each of us (including travelers) received a write up last week, with a page attached, showing us our overtime in the last pay period. I had 1.75 hours of overtime in the last 2 weeks. The issue is not in the write up (well it is because it is ridiculous), but in how they want us to handle our hand-off if a co- worker hasn’t shown up within the time limit given. As night shift, we are to have given report/hand- off and be punched out by 7:21 am. Each “violation” of this is a new write up. The hospital actually wrote that we are to write down shift report and hand it to the charge nurse, who would in turn hand it to the oncoming nurse. Or we can give the charge nurse shift report orally. (uum yeah that’s going to happen). We are then to punch out and leave the premises. (BTW.. by the time we know the on coming nurse is late, and we write down or orally give report to the charge nurse, it’s likely after 7:21 am…resulting in overtime.) Is this abandonment if we do this shoddy handoff? It is not what a prudent nurse would do. How can I leave my 7 PCU patients to the charge nurse? What if something happens to the oncoming nurse that she never shows up? What if 2 night shift patient assignment’s oncoming nurses do not show up for some reason?
This is a dangerous safety issue and I strongly recommend you contact both the facility risk manager or attorney and the state BON. You raised some serious questions and I would be checking my personal malpractice insurance coverage to be sure it is up to date. In this situation, if something were to happen, you absolutely could not count on the facility to properly defend you under their policy. They would look out for themselves first, last, and always. If I were the charge nurse, I don’t know how she/he could justify taking on your patients and perhaps others, even for a few minutes, to save the facility a few dollars. I would rather stay and do a direct hand-off and have the facility/system grouse about overtime than to have to explain to a patient, family, or attorney why I acquiesced to this policy. If they fire you, they’ve hurt themselves even more.
Just read Karol’s comment from Florida and it sounds very familiar, except in my case, I feel the circumstances are worse. I also work in an Assisted Living Facility, but in Mississippi on the 2p-10p shift. I am the ONLY licensed individual there (LPN) on this shift and cover the entire building myself, both Memory Care and Assisted Living (on all levels of assistance). Recently, the facility has been short-staffed and on numerous days there is no actual nurse to relieve me. The Health Care Coordinator (also a LPN) takes call from her home, which means there is no nurse to report off to or to count and hand off the narcotic keys to. I was instructed to give them to the front desk receptionist (a clerical worker) who places them in an unlocked drawer at the front desk. Although, we have receptionists there for a 24 hour period, I am very uncomfortable with this. My signature is the last one on the written narcotic record; thus if a controlled substance(s) are missing before the other LPN arrives to count at 0600, it is likely they will hold me responsible !!!! Also, I have been a nurse for a very long time and I never, ever leave a shift without giving another nurse a report. It may not be considered patient abandonment, but it sure feels like it! Although, I feel for my supervisor and her staffing issues, I worry about my license and legal/moral obligations to my patients /residents. Additionally, I try to give the RA’s (resident assistants) a brief report, but I and they feel like this is very unfair and improper responsibility for them. I also wonder if a nurse reporting off to unlicensed personnel is legal/kosher? Please advise as I am feeling very uncomfortable with these situations. Thank you kindly.
You are correct that you have some serious issues here! Two immediately come to mind as I read your note. First, regulations for assisted living and memory care (called Alzheimer’s/Dementia Care units in MS) are different for staffing requirements. Mississippi’s rules and regulations state clearly that “An RN or LPN shall be present on all shifts.” Not just available by phone but present. Your facility violates state rules if it does not have a licensed nurse on the unit when you finish your shift and this is absolutely a safety issue that could get the facility shut down or barred from the Medicare program. Your facility administrators need to address this NOW. (MS health facility regulations, Rule 50.2.1)
Would you be held responsible if you leave per your facility’s instructions? I think the blame would fall on the facility but you should be documenting for your own records who you talk to, what they say, etc. in case the BON were to investigate.
Second, regarding the narcotic keys, this is another serious safety violation. The federal Drug Enforcement Administration and the MS Board of Pharmacy would be the best places to start when looking for specific rules, but commonsense alone tells you that you cannot leave the keys to controlled substances in an unlocked drawer for hours at a time. The receptionist is not the appropriate person to watch that drawer or the keys, and you are right to worry about potential issues if something turns up missing during those hours. Again, document exactly what you’ve been told, by whom, and who handles the meds when there is no licensed nurse on duty. The state and the DEA will have something to say about this, I’m sure.
Staffing conditions are tough all over but we can’t put patients at increased risk and do nothing. That is unprofessional and betrays the trust patients and families place in us. Someone needs to contact the state healthcare facility licensing board and request their review and assistance ASAP. After a patient is harmed or medications are diverted is too late. Your instincts are spot-on — listen to them, and good luck!
Hello I am a new recent grad nurse (LPN) I’ve been working for this company for approx 6 months it’s substance abuse. I put my resignation letter that I would be leaving the company. My supervisor (who isn’t a nurse, because we have no DON) tried to talk me out of it. I told her I would think about it. After careful thinking I let her know that I won’t be returning after my last shift the following day. She told me to at least stay until the date I provided for my last day. So the following morning before going into work I noticed on the schedule she had me floating between two units and one of the units I am not fully trained in that unit yet and I have told her repeatedly I need more training but she brushes it off and keeps scheduling me in there. In addition to having me float she was requiring me to work 16 hours that I never agreed to. So I called out and told I will not coming in. She basically threatened me and told me my license is at jeopardy because “she left that unit unattended because she thought I was coming in”. Mind you there was a nurse there waiting for relief. So I told her I never accepted the assignment nor accept keys or even came in to clock in at the job. So she told another employee that she was going to report my license. She also called me unprofessional and told me that I don’t care about my career or saving lives. I just want to know would BON consider this abandonment and do I need to take legal action?
This is purely an employment issue, not a case of abandonment. You have the right to refuse an assignment and you have a professional obligation to refuse to work where you are not qualified, whether by skills, training or experience. If you accept an assignment, you are held to the standard of care of someone who does have the requisite skills and training. It is a safety issue for patients as well as a professional practice issue. I suspect that if this person called the BON, they told her something along those lines. I suggest calling the BON and talking to them to clarify by your state’s rules. You could also call the licensing board for that type of agency and put them on notice that someone is assigning inexperienced/untrained personnel to units and let them handle it. Good luck!
Am a nurse, so I went to work in the morning 7am, and after passing my morning meds I got a call from the DON by 10am that I should go to another floor and work, after pass meds to 25 patient. I refuse to take another assignment from her, she asked me to leave, and threatened me she will call BON for job abandonment, I didn’t leave I stay on the floor where I was assign to work….The DON later came with the corps to assist me out of the building, that am terminated. Am a new nurse, and am confuse as to refusing to take extra work load is abandonment. Pls explain to me, thank you.
I don’t have all of the facts so it is hard to know what was going through your DON’s mind. If I understand you correctly, you started on one unit but were pulled to another, which happens from time to time. One unit may need more help at the moment. Your charge nurse (if you had one) should have reassigned your patients. If you had no charge nurse, you should have had someone else to take over for you. Refusing to take another assignment is not abandonment. It sounds as though your DON went over the top, firing you and escorting you out of the building. I recommend calling both your BON and your state nurses’ association to talk with them about the situation. You won’t get your job back but you will get some clarity and you’ll get the facility on record as one that uses extreme tactics. Good luck!
I am a nurse at an inpatient dual diagnosis (mental illness and substance abuse) rehab. We have a men’s side of about 45 patients and a women’s side of the same amount. Then we have a extended stay facility next door with both sexes which hold approx. 45 more patients. Our facility continues to cut back on staff and recently we have had only two nurses to care for the entire facility on night shift. I was working a full 12 hour shift with a nurse who was only scheduled for a few hrs. There was another nurse scheduled to come in to relieve that nurse and finish the pm shift with me . The nurse who was waiting for her coverage had to leave bc she was finished her part of the shift but her coverage didn’t show up( due to an emergency). I was told to count narcotics with that nurse so she was able to leave but I didn’t know if someone was coming to replace her. I told the manager that I didn’t want to count bc I didn’t want to take that assignment due to having a very large assignment already and did not feel like it was safe. I feel like I get put in similar situations a lot and I don’t want to be accused of patient abandonment. Am I in the wrong? Do I have to accept the assignment bc I am the only nurse there? I feel like it’s very unsafe for me to be responsible for that many patients by myself.
This is a truly unsafe and untenable position to be in and I’m sorry you are caught in it. If you were to walk out, obviously that would be abandonment. As a practical matter, I’m not sure that refusing the assignment if there is no one else to cover would accomplish anything useful. I don’t know what state you are in but I recommend that you keep a careful diary or log of these situations — what happened, when, who you talked to, the resolution (such as it is), etc. This is for your own protection. If you do not have your own malpractice insurance, you need to get coverage STAT. As long as you work there, if something goes wrong, you can’t expect support from the facility. Next, find out if your facility has a risk manager or quality improvement person. Inform him/her about this situation. Third, find out if your facility gets funds from Medicare. If yes, the facility has to comply with “conditions of participation” which include adequate staffing and safe conditions. Notify CMS or the Joint Commission, or notify your state’s facility licensing board. There are risks to doing this — whistleblowers aren’t loved — but patient safety MUST come first. And, if you haven’t already, consider looking for another job. Decide whether staying is worth the risk to your license and to your patients vs asking (quite reasonably) for safe staffing levels. Good luck!
Hi,
I am a home health nurse, and working full time days which is going well, in CO. I picked up a night shift with a different agency (that I sometimes PRN for, ) a couple weeks ago, and the pt was sleeping at about 4 am I fell asleep on the couch. I got up and checked on my pt an hour later. I fell asleep again. The day nurse came.at 730 and I ran to the pts side immediately, changed diaper etc. Also his GJ tube was pulled on. From kicking on his tubes.it wasnt pulled out and I wanted to fix it by checking the balloon. There was no syringe available to use for this. The day nurse then pulled further on it and pulled it all the way out.
I left since my shift was over and the day nurse refused to accept report from me. She was on the phone. I called the clinic supervisor to report an issue with the GT
The next day I was called into the office and told that I was bring reported to the BON. I admit that I was sleeping earlier, but I saw her pull the tube out. I heard that the pt was taken to the ER that morning to replace the GJ tube.
Anything you want to comment would be appreciated. I have insurance.
If the agency says you abandoned the patient, I think you have a good argument that you didn’t. The day nurse might have refused report but by her actions, she assumed responsibility for the patient’s care. Sleeping on the job is a different issue and the BON may investigate but typically this is something between the employer and the nurse, especially in a first time, no prior occurrence situation. The tube is a toss-up — could you have prevented dislocation even if you were standing right there? Maybe. Maybe not. Should the other nurse have pulled it out? I don’t know but having to have the tube re-inserted is not unusual. It is not an issue for the BON. Go ahead and put your insurer on notice about the alleged report to the BON and then, if an investigator contacts you, you’ll know what actions your insurer recommends.
Arizona. As a “part-time” job I do skilled visits for a home health company. I was going to work 3 times a week and seeing 2 patients . I went to work as I always did. Then I just stopped going to work one week before my wedding. It was to much going on. I was getting married a week later, and was going to be out for a week for that. Then I started a new primary job a week before the wedding, and my schedule was W-Sa, 10+ hours. This took away from seeing my clients on TH/Sa. So, when I came back from the wedding I didn’t go back to work for them. Also, 4 days after getting home from the honeymoon I took in 3 kids on top of my 3 kids to help a friend out during her DCS case. Again I did not think about calling the office to resign once. They waited about a month and a half to tell me to call them and talk. This talk was to fire me and tell me they are going to report me to the BON for patient abandonment. I never was at the house and never walked out during the visit. They were my scheduled clients I would see T/TH/Sa on a regular basis, but then I just stopped going. Can they get me on patient abandonment if I just stopped going to work? They said they have proof of me abandoning them since they have no time sheets showing I was at work. They have no time sheets because I didn’t show up to work. It took them almost 1.5 months to talk to me about it and threatening to report me. I am very scared to have my license taken or have a bad mark on it. I have worked on and off with this company since 2013. They know how I work. I have never done this to them before, but they don’t see that part of me at all. I always worked extra when they needed it. I was the go to person when someone would call off. What do I do?
Yes, you should have called in, asked for a leave of absence or resigned but you already know that. To the core issue (Did you abandon your patients?), under the strict sense of the law, you abandoned work. You didn’t get up and walk away from your patient in the middle of a visit. From the employer’s perspective, they had no idea what you were doing, whether you were coming back, or if something happened to you. They should have called, but whether they did or not, they still had to find other nurses to care for your regular patients. What I suspect will happen, if they report you to the BON, is that someone from the board will investigate. They may or may not contact you in the process. Although to an attorney, this is clearly an employment matter, not a case of patient abandonment, that doesn’t mean the board will close the investigation with no action. They might have an informal hearing and they could reprimand you. Is this bad enough to revoke your license? Based on what I’ve heard about BON actions around the country, I doubt it. However, I do recommend that you contact your malpractice insurance carrier and let them know. If you don’t have your own policy, you should find an attorney in your state who has experience helping professionals defend their licenses (contact your state nurses’ association or The American Association of Nurse Attorneys for starters) and talk with that person. You’ll have to pay a consulting fee but you should NOT go to any hearing or sign any paperwork from the board without first talking to an attorney. As any attorney will tell you, your prior work history is one factor that may or may not work in your favor. Offering excuses doesn’t help — put yourself in your supervisor’s position. What would you think of a nurse who did what you did? Is this the behavior of someone who is an accountable, responsible professional? Focus on behaviors you would expect from a nurse caring for you or someone close to you. Own what you did, talk with an attorney, and use this experience to improve your professionalism and you’ll go a long way toward avoiding future problems.
I am a nurse i work in a facility where the DON is a past State Surveyor. I was assisgned to do treatments for that shift. I completed my treatments and i quit without notice. I notified the RN supervisor that was working also. Now the DON says she is going to report me to the BON for abandoment when there was adequate staff and nurses in the facility and my work was done. I was scheduled for a double shift never accepted report from the nurse going off shift i left 1 hour before shift change. Its a very hostile and i did not abandon any patient.
The question the BON will ask is, Did you leave your patients in the middle of an assignment with no handoff and no care? If the answer is no, you didn’t abandon them. Going back to my post, there is a difference between patient abandonment and employment issues. Compare these scenarios: (1) A nurse has been at work for several hours and decides she/he has reached a limit and that quitting is the only option. The nurse signs off charts, gathers up his things and leaves without telling anyone. He emails his resignation “effective immediately.” (2) A nurse works 7 of 8 assigned hours and finds out that she is now scheduled to work another 8 hours after this shift. No one asked her. The nursing office just called and said “you’re staying over.” The nurse has completed all care for her assigned patients and is charting, getting report ready. She tells her supervisor that she’s had enough and is quitting, effective immediately. She gives report to the supervisor, doesn’t stay to the end of the shift, turns in her badge and leaves. (3) Same as #2 except that the nurse stays for the last hour, notifying the supervisor that she’s quitting as of the end of this shift. She gives report, refuses to accept the next assignment and leaves.
Most authorities would agree that scenario 1 is abandonment while scenario 3 is strictly an employment issue. Scenario 2 teeters right on the edge. As long as the nurse notified the chain of command, reported off, and didn’t leave patients without anyone to care for them, most authorities would view it similar to a nurse becoming ill or having an emergency that required her to leave early. No notice, no handoff, patients unattended, no one aware the nurse has left would equal abandonment.
I recommend notifying your professional liablity insurance carrier and keeping careful documentation about what happened, when it happened, who you talked with and all the other important details. If the BON does notify you of a complaint, be sure to talk with a lawyer in your state who is knowledgeable about professional license boards and disciplinary actions. Do not try to handle the matter yourself.
Abandonment, no matter your location, is the same definition as I gave in the article: if you are a healthcare provider and walk off the job/away from caring for an assigned patient, with no notice to anyone, and you fail to ensure the continuing care and safety of your patient, you could face a charge of abandonment. The state licensing board has to investigate and make a decision. The provider being investigated should receive notice in writing of the charge and have the opportunity to answer. I’m not licensed in Maine (for law or nursing) and can’t give you legal advice. I recommend looking at Maine’s CNA registry website: https://www.maine.gov/dhhs/dlc/cna/home.html and calling the office to talk with an official if you have specific questions that the website doesn’t answer.
I am the only nurse and work 12 hours night shift in locked long term facility in Texas with over 30 behavior residents. My employer is insisting that I clock out for 30 minuets each night. Is this legal and is it abandonment? Also how do I protect my license?
Clocking out — as in clocking out but staying on the unit? Or clocking out and actually leaving the unit? The first one is only slightly better than the second and neither is good. Your employer may be trying to avoid paying you for a meal break but this is a poor reason when you have one nurse, no coverage, and over 30 patients. If something were to happen to one of the patients during that 30 minutes, even if you remain on the unit and respond immediately, a good plaintiff’s attorney would have the facility in a locked grip and the state licensing board for facilities would be all over it. Contact your state board of nursing and the long term care facility licensing board and ask them about this situation and their recommendations. Also contact your liability insurance carrier and let them know about this situation. And document everything for your own files: names, dates, times, conditions on the unit, quotes, copies of anything in writing, etc. Clocking out, even if you are still physically there, creates a record that says patients were left with no licensed provider caring for them for 30 minutes and that is abandonment, no matter what your employer says. In the event of patient harm during that period, it becomes your word against the plaintiff’s and the facility will likely deny ever telling you to do such a thing. Stay strong!
I am the director at a community based organization that provides in-home services and programming at senior centers. Our FT and PT RNs provide health outreach and supervision to in-home direct care staff. In addition, when they are in the office they will typically respond first when there is a fall or illness at our senior center, which is adjacent to their office. This ancillary responsibility is in their job description. Recently they have all asked me to take that out of their job description and to not call them for falls or other situations. They said they are concerned about abandonment. There is no ongoing patient relationship, it is often providing clean up and a bandage or immobilizing when waiting on EMS. We have other staff who are trained in first aid and CPR but our nurses are our most qualified and handle these infrequent calls for help better than the rest of us can. Is their concern for abandonment founded? Is there something I can do to alleviate their concern?
This is an interesting question. Not knowing all the facts, I’m answering based only on what you’ve said above and I can see several angles here. First, as long as the nurse assesses the person for any serious injury (the basics: airway, breathing, circulation, broken bones) and is providing only first aid, I don’t see evidence of an on-going nurse/patient relationship for the nurse to abandon. If the person requires a trip to the ER, the nurse hands off to EMS –> no abandonment. If the person insists that s/he is fine and declines further treatment, the person is leaving, therefore no abandonment. If the nurse sees anything that s/he thinks requires additional treatment, get EMS there and hand off the patient. I would definitely recommend a log of any incidents with a summary of the date, time, circumstances, assessed injury, what was done, and whether the person was treated or transported by EMS or declined further assistance.
The reason I say this is because of the other pieces of the situation, i.e., whether the nurse is acting as a good Samaritan (not being paid to do this) or in case the injured person comes back and claims negligence. Responding as you would if a neighbor falls outside or something similar is acting as a good Samaritan with no expectation of pay. You act as any other nurse would — using your knowledge and skills to assess for significant injury, ensuring an airway, controlling bleeding, etc., protecting the person until EMS comes (if necessary), and advising the person to seek follow up care if the injury doesn’t seem to warrant a trip to the ER or urgent care.
If your nurses (and any other employees) are expected to respond as part of their job, they need to be careful to do only those things they are trained and are capable of doing. Obviously a nurse is held to a higher standard than the receptionist or a visitor walking in the door. The key is to do what any other NURSE would do under the same or similar circumstances — no less, and nothing outside the scope of licensure.
Also note that if there is any formal agreement that nurses will respond in these situations, then NOT responding is a breach of contract and could be labeled abandonment when there is a duty and the nurse doesn’t act. If you do have a formal agreement and want to take this particular service out of the deal, you’ll have to have an agreed-upon, signed amendment. You can’t just unilaterally stop providing the service.
Again, this is just based on what I’m reading and thinking as I read. As you can tell, there’s more to this than you may have thought. I would recommend running this past your company attorney or risk manager. Unless you are in Tennessee, I can’t give you legal advice, only an educated guess of the possible issues that jump out at me from your description. Good luck!
Thank you so much, I appreciate your prompt reply and guidance.
I was working in a nursing home yesterday. A 12 hour shift. I was on my 8th hour when my Director of Nursing and I had a disagreement regarding her docking my pay. Finally after lots of frustration I walked to my DON’s office and gave her the keys to my medication cart and told her I was leaving. At that moment there were 5 nurses (including my DON) in the unit and 4 of which that were not assigned patients. I would never leave my assignment knowing there would be no one there to care for my patients. However, in the eyes of the law, is this abandonment? If so, should my employer report me, what should I expect?
I don’t know what your particular BON will say. Based on what you’ve said, you felt you had to leave before the shift ended and you handed off your patients to your supervisor. That doesn’t meet the definition of patient abandonment. Would it have been better to finish out your shift and deal with the issue afterwards? Yes, but this is an employment issue, possibly a question of professionalism (unprofessional conduct), not abandonment, according to the definitions published by those boards of nursing on the record about this subject. You might want to call your BON and talk with someone there about what happened to see what they think.
I have been wondering if abandonment is when a nurse comes in at 3 am to be a float nurse. Then at 7 am another nurse comes on shift and says she is to be to be the float nurse. The nurse working 3 am to 3 pm gets upset, throws her keys on the counter and another nurse picks them up right away. The nurse then leaves the facility. She is called back to count narcotics, which she does but leaves again. I feel this is abandonment since she has been there since 3 am. I want to report this to the appropriate people. This same nurse did not show up for work before this incident, was called at home and said she was to come in to work. She said I am not coming in because I am not marked to work on the schedule I have. So she did not come in to work.
Based solely on the facts you’ve given, I would be concerned about this nurse’s behavior for several reasons. I’m hearing several employer/employee issues here, which are not abandonment (not coming in to work if not on the schedule, etc.) I would also be concerned about her leaving in the middle of the shift. Without more information, I would say it leans very close to abandonment and unprofessional conduct. If this nurse has a history of conduct issues, the state BON may want to know and investigate. Certainly the facility’s nursing director should look carefully at this nurse’s history and conduct.
I work at a small hospital in the OB dept In Connecticut. When a coworker calls out due to illness or such, every effort is made to find help to replace the nurse otherwise a nurse from the previous shift will be mandated to work the next 12 hours in addition to the 12 hours she had already worked. As this is happening right now, I am working 7 pm to 7 am and am being mandated to also work 7a-7p to cover the sick dayshift coworker. How do I find out concrete information regarding if this is legal or not. Not to mention, at 7 a.m. Im to work on a different floor because we have no patients in OB at this time, (it is a very small hospital) which I feel is not safe. The whole patient abandonment remark has been thrown around if we refuse to be mandated. We are in union negotiation at this time with the hospital and I don’t know if that makes a difference but I just think this is an unsafe situation all together. Ive been a nurse for 13 years and moved here from Missouri and I have never worked in a facility that “mandates” a nurse to work over time or disciplinary action with be taken until I moved to Connecticut a year ago.
For starters, look at https://www3.swipeclock.com/blog/employers-understand-how-to-manage-overtime-regulations-in-the-healthcare-industry/#solutions. This page has information on several states and mandatory overtime, including Connecticut. Not every state is listed here but CT is. Also call the CT Board of Nursing and the CT Nurses Association. There are many reports/studies that show the dangers of mandatory overtime and how it impacts patient safety. Being floated to a floor for which you have no training or experience is also dangerous — refusing such an assignment is not abandonment. If you are a member of the union, you can also call them to let them know this is happening. Swipeclock specifically notes that nurses in CT cannot be penalized for refusing to work mandatory overtime. Good luck!
I work in licensed Assisted Living with approximately 65 residents aged 65 and older. Residents range from completely oriented and independent to total care.
I saw a similar question above but I had a question about what constitutes “licensed” supervision. At night I am the only nurse for all the residents but we do have 4-5 CNAs on duty. There are no other staff members in the building.
We are being mandated to take a 1/2 hour lunch mid shift. Can I give report to a CNA and have it not constitute abandonment or does it have to be and LPN or RN?
I fear that if something serious were to happen while I am “clocked out” that the CNAs would not have the skills to act appropriately so I am erring on the side that it is a risk to my license and my residents’ safety.
I can’t really find anything specific to abandonment in my state nursing regs. Thank you so much!
You are right to be concerned. CNAs are not “licensed” personnel. If something were to happen while you were clocked out, everyone would be in a bad position. Check with your state’s assisted living licensing board for regulations about required personnel. Ask if CNAs are allowed to function unsupervised — which is what they would be doing if you clock out. My guess is no. Even if you remain on the unit, the “clock” says you aren’t there. Plaintiff’s lawyers would have a field day with this. And you are either working while not being paid for those 30 minutes (which is a no with the Department of Labor) or you are off duty for those 30 minutes, which leaves CNAs unsupervised. Patient safety and your license are great reasons to bring this up with the licensing board, your state nurses’ association, and facility management. Good luck!
I came into work on a thursday 3-11. I was the only nurse scheduled to work, taking care of 54 resident’s with 4 certified nurse aides. I made the mistake of clocking in and taking the keys. One of the 7-3 LPN’s stayed till 5pm, after that I was alone.
If this happens again would it be abandonment if I didn’t clock in or take the keys and that I was leaving if they didn’t get me any help?
The key to actual abandonment vs. an employment issue is whether you “accept the assignment.” I think you have a good understanding of that — if you DO NOT clock in, you have not officially reported for work. Once you clock in, your option is to refuse to accept the keys and the assignment — and you have to do this assertively, clearly: “To be clear, there are 54 residents and 4 CNAs. I am the only licensed nurse scheduled for this shift. Is that correct?” “Yes…” “OK. I refuse to take this assignment under these conditions. I am CONCERNED, I am UNCOMFORTABLE and this is a SAFETY ISSUE. If you can guarantee me another licensed nurse to work the shift, I will stay.” (The concerned, uncomfortable, safety statements are part of TeamSTEPPS safety training — go to http://www.ahrq.gov and search “TeamSTEPPS” for a self-paced learning program if your facility doesn’t already offer/use the system.) You need to decide beforehand what you are willing to do at this point. If you turn around and clock out, you’ve probably lost your job and you need to know that. Document everything in writing immediately or as soon after as possible. Keep it in a safe place.
Your better option is to notify administration now about what happened and ask them to work out a solution if there is a next time. If they tell you the staffing is sufficient, decide whether you want to continue to work in those conditions. Also call your state facility licensing board or the Centers for Medicare and Medicaid (cms.gov — I assume from your wording that this is a long-term-care facility) and let them know that you are concerned about unsafe staffing levels. Also talk to your state nursing association and find out about possible resources to help you, particularly if administration requires you to clock out for a 30-minute meal break, because then there is no licensed person available and CMS requires one 24/7. Good luck!
It seems to me by what I have already read that it would not be patient abandonment.
We are chronically understaffed. Nurses and aides routinely. Come in early and/or stay late.
The company is being investigated by the U.S. department of labor, for failing to employees for all hours worked, paid employees straight time for overtime. Sorry i took up two spaces.
That’s OK! I don’t usually respond while someone is typing! If DOL is already investigating, CMS should know about the situation too. And, if the facility is surveyed and accredited by Joint Commission, they should hear about it too. Safety issues are taken very seriously. Remember that this is for resident/patient safety, PUBLIC safety, and your professional license and career. Consider your options and act for everyone’s safety!
I came to work one night 10-6 at a LTC after clocking in and getting report myself and another nurse we are both LVN find out that it was no CNAs on the floor to help when we called our supervisor we were told we will have to deal with it because it was our responsibility to take care of 42 patients just the 2 of us, we told out supervisor that we wanted to file a safe harbor and she just told us whatever, that night was horrible we even have 2 emergencies. In the morning we send our supervisor a message telling her that we left the paper for safe harbor under her door. My co worker came that day to make sure she had sign the paper and was told by the owner who was at the facility that 42 patients for two nurses is not a safety issue and that they were not signing the paper she try to explain to him about the emergencies we had and everything else and he still responded that is was part of our jobs and not any safety issues were broken. My question is if I came to work and see that we have no CNAs for the night and I have not clock in or take any report can I refuse to take the assignment and leave?
First, if you chose safe harbor, I’m assuming you are in Texas, because they are the only state that I know of with this option. So, if you are in Texas, call the state Board of Nursing first and let them know about the situation, because the LTC must respond according to state law and regulations. It doesn’t matter what the owner says or thinks. Second, call the state licensing board for LTC facilities and report the situation, because it IS unsafe no matter what the owner says, and the state has an obligation to ensure resident/patient safety under state AND federal laws & regulations.
Next, to answer your question at the end, under the circumstances you mention, you could refuse the assignment and leave. That would be between you and management, and you probably would be out of a job. I would expect them to try to report you for abandonment, but this set of circumstances doesn’t meet the definition for abandonment.
My question to you is whether you could bring yourself to do that? Leaving that many patients with one nurse is a tough call. Management would have to get someone else in but I’d have a hard time sleeping, worrying about the other nurse and the patients. Middle ground is to accept the assignment under protest — which is what safe harbor really is. I hope you and the other nurse kept a copy of the form you submitted. If not, the two of you should write a joint memorandum for record stating what happened before, during, and after (the bit about the owner goes here) with names, date, times, facts, who said what in quotes, etc. This is some protection if someone were to come back later and accuse the two of you of malpractice — you recognized the situation, tried to get it remedied, and were told to deal with it. That puts the burden right back on the owner, where it belongs.
Do follow up with the state boards and good luck!
Hi! I’m a community health nurse at a nonprofit community based organization, providing skilled nursing to patients in their home along with other RNs. I have patients delegated/assigned to me, but we frequently “cover” patients for each other if nurses call out, are on vacation, or just for convenience.
My new director wishes to “take away” our compensatory time – an internal understanding that if a nurse works and sees patients on holidays or weekends, she “gets back” those days during the following week – implemented to prevent us from burning out working Mon-Fri 9 to 5 + weekends + holidays. However, this understanding has never been written officially in any policy and we are exempt employees.
If my internal documentation is up-to-date, and there are other nurses available to cover the assignments, is there patient abandonment involved if I consider quitting my job with short notice, even with active patients on my caseload? The patients are technically my “assigned” patients, but visits are delegated and shared amongst the nurses.
The nurses are adamant on keep this compensatory time and we’ve advocated for having a discussion with human resources and finance to figure out the “legalities” and workload. Because we are more than just nurses – essentially skilled nursing + coordination of care – we are trying to prevent feeling burnt out in our small organization with an increasing caseload.
Thanks for your advice!
What you describe is a pure employment issue. If you are actually in the middle of a visit, stop what you’re doing, and walk away, that’s abandonment. Quitting because the work conditions or terms have changed is not abandonment. I do encourage you to try to talk this through with HR and management to see if you can reach an agreement, but if you decide this job is no longer for you, you can submit your notice and leave. Good luck!
Hi, my situation is a little different and I would like to know if it could be considered job or patient abandonment? I worked a clinic in a small town of about 3000. we serve about 500 patients. we had a patient come in and we had him be seen by the telehealth NP. we suspected a slow GI bleed, pt. was obviously anxious, pale, sweating slightly elevated heart rate but stable. c/o of bloody stool, bloody vomiting, some nausea. NP felt best he go to the local ER to be seen in person and would need some testing that could not be done in the clinic. I as the RN as well as the NP did not feel it emergent enough to need 911, however because of his high anxiety I did not want him driving himself think of safety for him and the public. in hindsight I made a quick decision that the LPN and myself would take him up to the ER which was 6 blocks away and only took about 5-10 min. The LPN drove him in his truck and I followed behind to bring her back to the clinic. the NP on telehealth was aware and we told the front receptions. No other patients were scheduled and we had no walk ins in the few min we were gone, however I did not think or take the time to notify my supervisor 100 miles away what we were doing. Now both I and the LPN are on administration duties and fear for our jobs. Is what we did job or patient abandonment??
Goodness. Is your supervisor really upset that you and your co-worker drove a patient to the ER up the street? From a risk management perspective, you could have called an ambulance (because neither of you had the equipment to treat if he’d deteriorated — and I think he was more unstable than you realized — I was married to a gastroenterologist and I worked ER while I was in law school, thus my long-distance opinion.) However, being well acquainted with small towns, I think what you did, considering the patient’s condition, the distance to the hospital, the time it would have taken to get an ambulance there, the ultimate cost to the patient, and the potential liability of the clinic if you’d let him drive himself, was the right thing. You did not abandon any patients. Presumably, the telemed NP was available if something serious came in but you weren’t even gone 15 minutes, correct? Was the clinic totally unmanned? Plus, you weren’t on break; you were caring for one of your patients. Ask your supervisor what she/he would have preferred you do and then make sure you follow instructions in the future, but no, I don’t see any abandonment of any kind here. You minimized the time you were both out and you ensured a patient’s safety as well as anyone else on the street between the office and the ER. If no one was left at the clinic for that brief time, anyone arriving with a true emergency would have gone to the ER. The only reason I’d have a problem with this is if you made a habit of both leaving the office. Otherwise, you did the right thing for the patient.
Home health RN who always has a nursing assistant on shift (12 and 8 hour shifts) in CA. In regards to an Emergency situation, what if the emergency is for the nurse working in this sort of unsupported environment (no charge nurse, etc). Say the RN working suffers a stroke, or MI, or detached retina? All of these require prompt transport to a hospital to prevent loss of life/function, and depending on how severe the symptoms may not even allow the RN to make a call to management/agency. Would the BON consider any charge of abandonment in such an extreme case? If the patient suffered injury due to the ill nurse not being present would a lawsuit even stand a chance for damages? Thanks for you wisdom.
I don’t know on what grounds a BON could charge abandonment in this situation. No one expects the nurse to continue working despite their own medical emergency. Presumably someone from the nurse’s family, if the nurse can’t do it, would notify the agency/company as soon as possible. The next patient would likely call if the nurse didn’t show up and that would alert the company that something is wrong. Abandonment is based on intent and knowledge — the nurse intends to leave, fails to notify someone or arrange continuing care of patients, and knows (or reasonably should know) that they should notify and do a proper handoff.
Im a cna. This is what happened a month ago. I just finished working my evening shift from my nursing facility and now Im about to work my regular noc shift as a double on the same assignment I’ve work that evening. I went for a little break and when I came back, the cna that pick up a shift that night wanted my assignment. When I confronted her that it was my assignment, she argued that her name was on the assignment sheet to work that assignment. But I am the regular nightshift cna and that has always been my regular assignment. So when she would not switch, I told the other nightshift cna’s on the floor that I am going home and I left. The reason I left is because I didn’t feel safe working there that night with her being around. Every time she works nightshift, she’s always sleeping and it takes her half an hour to 45 mins. to answer her call lights. I reported her one time on day shift that she would disappear everytime we have to pass trays to management but they never did anything. She work two other jobs that when she goes to our facility, she doesn’t have the stamina to do her job. And let the other cna’s do her job. It is very unfair for the us–other cna’s. But they still put her on schedule to work night shift all the time to work the other assignment. Except that night . She wanted my assignment. Is my situation abandonement?
Not knowing where you are located, I can’t say for sure whether your state includes CNAs in the category of those who can abandon patients. Usually this is applicable to LPNs and RNs. It is certainly an employment issue. You allege that this CNA doesn’t do work she is assigned and that the rest of the staff has to cover for her. That is a safety and patient care issue. From an employment perspective, leaving because you don’t like the assignment given you is a matter of concern, both from the employer’s perspective and from a patient safety perspective. There are other troubling matters here too. I’d encourage you to document for your own record each incident where this staff member sleeps, fails to answer lights, — anything that puts patients at risk. Talk with the state nursing facility licensing board about your concerns and ask them what they recommend you do. Good luck.
I am a caregiver that is not licensed. I accepted a live-in home caregiver from Sunday through Thursday every other week. However, it changed from every other week to every week. I was not being paid on a set schedule. I had to ask repeatedly when I would be paid. I was never paid with the check that was promised. The patient paid me with $2000 cash but still owes me $3950. On a Sunday I was told that they were replacing the entire crew the up coming Saturday. After hearing of this and finding that they were not paying the employees like they were suppose to I decided not to stay any longer. I sent a gmail to the patient’s “manager” who suppose to pay employees and take care of problems stating I would be leaving the next day, Monday. First, they were still suppose to pay me $3950 but were not doing so and the patient did not have Medicare services to cover expenses for his problems. He did not have diagnoses anywhere in the home showing exactly what we were suppose to treating him for. He was a full blown alcoholic. He was ambulatory with his wheelchair. I had enough of the patients’ anger, verbal and emotional abuse and lack of payment. I left without the manager being there. I told the patient that he was capable of going to the restroom without urinating in the bed. He told me to leave and not let the door hit me on the way out. He told me to leave my keys and never come back. Upon leaving I called the police to let them know that the manager (Lee) had not shown up and the patient told me to leave. The police suggested that I call the Elder Abuse Hotline to let them know. I told her what was happening and she asked if he was able to use his wheelchair to ambulate around the home and I said yes. She asked if he had Home Health Care and I said yes. I also told her that he has his own cell phone beside his bed and could call anyone he needed for help. I am taking the patient and manager to court to recoup my pay. The manager is saying that he is not going to pay me because I left the patient alone and is calling that abandonment. I appreciate your thoughts and suggestions with this matter.
Please understand that I can’t give you legal advice. If you think you’ll be sued, you need to consult a lawyer in your area. Based on what you stated, you were hired as an individual to provide in-home services for a man with multiple unspecified problems. You weren’t being paid, the man himself told you to leave after being verbally abusive and angry, and you tried to ensure he wasn’t left in a dangerous position. Since you aren’t a licensed healthcare provider, it isn’t a question of abandonment. This is a possible breach of contract (not being paid for services rendered) and perhaps misrepresentation of the working conditions/situation if you weren’t told about the man’s behavior & problems. It sounds as though you made a good faith effort to make sure the man was safe before leaving as he instructed you to. No abandonment. Take the issue of pay up with your local court. Good luck.
I just wanted to say thank you for your thoughtful responses and for this helpful info! This has helped me delineate abandonment versus employment disputes. I really appreciate the time you haven taken to answer these complicated questions.
I am been an rn since 1978, and worked at the same facility for last 40 years. I work in critical care. When covid 19 started in March. I started inquiring about a leave of absence, unpaid. I am almost 70, have had lung surgery last year, and have treated hypertension. I continued to work while all the paperwork was filed, and then more paperwork refiled. I am part time so did not qualify for fmla. Finally on April 28th, I was told my leave was denied. I was never told anything about the cares act. Or offered any accommodation. The last day I was on the schedule was May 2. I have not been at work since. And I was not scheduled. Through May orJune. On Monday the 18th, I was called and told I had to work my two days that week, or resign. After a conversation, and much distress, since I am out of state doing some emergent family issues, I told them I could not do that or resign. Checked my schedule that day and was still not on either May or June. My internet here is poor and phone service intermittent. I got a email yesterday, that I have now been scheduled for Monday the 25TH, Memorial Day, and if I do not report I will be charged with abandonment and be terminated. Please give some guidance. Thanks
I am sorry you’ve been put in this situation. Your risk factors make you unsuited for working with COVID patients and the facility should never have considered it. Refusing to even come in is not abandonment. As I noted in my article, this is an employment issue, not a patient abandonment issue. No assignment, no accepting the assignment, no leaving with zero coverage or notice. You may well be terminated but that’s an employment issue as well and one you can speak to with a clear conscience to future potential employers if you want to continue working. Most states are “at will” employment states, meaning employers can hire and fire for good reason, bad reason, any reason. The exception is when the action runs counter to public policy. If you are interested, you can talk with an employment law attorney about whether the hospital’s actions might run counter to public health practices and public policy by attempting to coerce a medically vulnerable nurse to work during an epidemic. You can also send your resignation to HR before tomorrow stating your reasons, rather than letting them terminate you. But as for a BON complaint about abandonment, this doesn’t qualify. Good luck and good health!
Thanks so much, I have arranged coverage for myself for tomorrow and next Friday. And this was cleared with my manager, not my director, but she was on this weekend. Since I have coverage arranged, it should give me some time to ascertain what to do next. Florida is a right to work state, I am a native Floridian, hopefully I have some wiggle room. WHat if the director goes ahead and terminates me anyway? Hopefully that will not happen. Thanks again.
Here various fixes for it is and it’s not abandonment have been discussed here. They are must read for many. This article is a good one to look at. I like how you have researched and presented these exact points so clearly.
I’ve been in the healthcare field since 1975 and became a RN in 1996. I work only the weekends at a long care faculty that have just hired two new young managers, both Lpn. They seem like they were related as close as they are. I’ve had one talk down to me and go over my work after questioning me about a resident. Then this weekend I get to work it feels like 99 degrees in the building. The state had already been there earlier in the week because of the heat. Then 2 hours before the shift ends I get in a argument with the manager because she yelled at me, she called the DON and I was told I was suspended and needed to clock out, she told me to get my stuff and “get out” I gathered my things to leaves then she follows me down the hallway and stated you need to count with me before you leave. I told her I wasn’t counting with her I getting out just like she said. Then I had the administrator call me and threatened to report me to the board of nursing if I didn’t count with her, he was going to report me for abandonment. I ended up counting with the ADON and left. Now is that abandonment if they tell you to get your stuff and leave you are suspended then when you refuse to count it abandonment.
OK, let’s sort this out. First, not counting is an administrative action, not a patient care action. Not counting could mean you’d be responsible for any “discrepancy” that later turned up, no matter what actually happened. So you do not put yourself in those situations. Always try to close any potential traps. Counting was the right thing to do from an administrative and self-protecting perspective (not saying that one of the LPNs would have falsified records but if something had turned up missing or unaccounted for, you would legally be responsible.) Not counting is NOT abandonment.
Second, if you are instructed to get your things and leave because you are suspended by administration — the chain of command — that is not abandonment either.
The upshot is no abandonment in any of this. I disagree with LPNs in a supervisory role over RNs but that is another issue. The takeaway from this is to protect (1) yourself and your license and (2) your patients by making sure that you can’t be put in an unsafe position professionally or legally after the fact. Close those loops, do the proper handoff, sign off on documents, be safe for you and your patients.
There is a Nurse in the state of Florida that gave two weeks notice and quit her job as she can not handle working 80 to 90 hours a week in a supervisory role for months on end. The director touted to the other employees that she is going after her for employment abandonment and that FOUR weeks notice is required. Is giving only two weeks notice considered employment abandonment in Florida during COVID?
First, I am not licensed to practice law in Florida. I’d encourage any nurse anywhere to consult with an employment attorney if s/he is worried about potential consequences from an employer. THAT SAID, I wish that director luck because I don’t think she will get anywhere. Most states, including Florida, are at-will employment states, meaning the employer can hire & fire for any reason at all unless it is specifically against the law, AND employees can quit at any time, for any reason. A quick search of the internet turns up thousands of sites that confirm that Florida has no state or federal law requiring advance notice of quitting. As with any other employer policy, a clause requiring employees to give X number of days or weeks’ notice is not a law with fines or other penalties for failing to follow the policy. If an employee quits, the employer can’t force the employee to stay or punish them for quitting. There is no legal claim for “employment abandonment.” The state BON will not get involved in an employment dispute. A search of the FL BON site shows no notice requirements or requirements to keep working. Each nurse has to take care of themself. You aren’t obligated to work overtime for months on end, sacrificing your health to fill an employer’s need.
Was it abandonement if you told nurse yournot going back because you had bearly made recovery of pneumonia and then they try to put you on covid unit.
I just saw your post. Short answer: no, it is not abandonment under those circumstances. That is a straight employment issue — you have no business being sent to a COVID unit so soon after having been sick yourself — that puts you and the patients at risk and the facility could be held liable if you or a patient became ill or died because of the assignment. Abandonment would be you accepting an assignment, beginning care, and then walking away from the assignment. Hope this helps.
I am a dsp in Oregon. Lately we have been experiencing high staff turnover and shortage of workers and workers coming in late. Ive went through the chain of command and havnt got any response except theyre trying to get people. Who else can I talk to about this? I work a 9 hour night shift I wont leave my people alone but im tired of staying late and nobody doing anything about it. please help
Once you accept an assignment, you must stay with it until you can properly hand off responsibility for those patients to the next person to care for them. If the next staff member is late showing up, either someone from higher up should relieve you or you must stay until someone arrives. Walking out is abandonment and unprofessional behavior that could get you in trouble legally. If management doesn’t have any solutions, your choices are to 1) continue to work under the current conditions, 2) work with management to find temporary or permanent solutions (agency or temporary personnel? active recruiting efforts?), or 3) quit and find work elsewhere.
If you feel the conditions are unsafe, either for you or your patients, or both, be sure to document for your own records what happens, when, who you notified, their response, etc. You can also contact your state board of nursing to ask their advice, and the state agency that licenses your facility to let them know of unsafe conditions and ask their advice. If you go this route, you’ll need more than “I don’t think it is safe” to back you up. You’ll need statistics — staffing ratios, how long you have to stay over (minutes? hours?) who you notified, how often this happens, and so on.
Everyone is struggling, stressed, burned out, overworked, and more these days. You know what your patients need and that you must keep them safe and cared for. How best can you do that? Can you continue to do that under current conditions? Those are the questions you’ll have to answer. Good luck!
Hi!
I am a CNA in Minnesota. During my shift I began to throw up. I notified the nurse who I report to and they did nothing about it. I decided to continue working in fear of being reprimanded even though I kept throwing up throughout my entire shift. An hour before my shift ended I was told I needed to stay another 6 hours (on top of my 8 hours) because they were short staffed. I told them I could not stay but they said I had to. When my shift ended at 2:30 I walked out of the facility. I already had my 2 weeks in at this time and emailed my bosses that that would be my last shift and I will not be coming in again. There were 2 licensed professionals (RN and CNA) on the unit when I left. Could I be reported to the BON for abandonment? Will this ruin my chanced at becoming an RN in the future.
Your shift was over and you refused the assignment. That is not abandonment. You left the patients with the RN and her team AND you had no business being there anyway since you were ill. I don’t know whether this is a hospital or a skilled nursing facility, but the risk of passing whatever you had on to patients outweighed everything else. If the facility is a SNF, you should contact the state licensing board for SNFs and let them know what happened. Whether that board does anything is up to them. Not coming back to work is also not abandonment. You were entirely justified and any reasonable RN would have sent you home during the shift rather than risk patient health. So, no, it shouldn’t affect your future career plans, and if anyone ever asks you, just tell them what happened.
My male co-worker who has a hx of bullying me and others x 10 years. (i did not report him before for fear of retaliation from him and my boss) bolted up to the second floor of the inpatient school I was working at. He was extremely angry and started yelling and coming close to me saying get downstairs now. Witnessed by a NA. I felt threatened and did not feel safe. ( I was taking care of 7 inpatients and he had 2 nonurgent pts coming in)
He continued to bully, intimidate me and mock me the rest of the night. I tried to stay away from him then at the end of my shift I gave him report on these 7 stable patients that we have had in our facility 7 days — quarantine. even though he ignored me and then I told him i was leaving at 11p (I was only scheduled til 11p so I did not leave early). ( he worked 7p to 7a) Also told another nurse (11p to 7a) I was leaving (she was coming in) and told her I gave report to him (the nurse who bullied me. )
The next AM I told my nurse manager about his bullying and that I felt unsafe working with him. She minimized the situation and said well maybe he handled it wrong( she and I had a previous issue regarding COVID protection and now i have to watch my back for fear of retaliation from her). Anyway my manager told him I reported him so he told her I did not give him report before I left the night before and she believed him and he made up other lies.
I was assigned to work with him again that second night even though I was concerned about his bullying and my safety. I tried to give him report x2 that second night and he ignored me and said all set both times so I waited and gave 11p to 7p nurse who works with him report.
I spoke to HR who is friends with my Nurse manager and it seemed like HR was not going to do anything so next day I quit because I am afraid of this co-worker and not supported.
Now concerned about my manager reporting me to BON for abandonment because my co-worker lied and said I did not give report when I left the night he was bullying me. Not true because I did give report plus names of pts were written on whiteboard(pt names dx etc) but no witness. He lied to distract from his bullying. This employer falsely reported another nurse to BON and fired her. BON dropped case against this nurse. So if my employer reports me to BON for abandonment…is this abandonment? will they will not hear my side til later or do I ask BON about this earlier before knowing if they reported? Thank you!
I see that you submitted this twice, so I will answer just one of the submissions. First, if you have not already done so, document for your own files everything you can about this individual — who, what, when, where, how, witnesses, etc. — and hang on to it. Second, report this co-worker to the BON for unprofessional and unsafe conduct. This is absolutely inappropriate behavior and presents serious risks to you, other staff members, and to patients. The fact that management brushes it off is not your fault and they are on notice of this person’s problems. Doing nothing will get them in hot water sooner or later. This co-worker’s behavior REQUIRES reporting and investigation! Third, you might consider talking with an attorney about filing a claim against the facility for a hostile/unsafe work environment. Make sure you stay vigilant and protect yourself because this employee sounds dangerous, even if you no longer work there.
As for whether you abandoned patients, you did not. You made reasonable attempts to give report, you informed other staff members of the situation, you’ve informed management of the problems. This is not a case of abandoning patients. If, by some chance, your employer does report you, you will have an opportunity to talk with the investigator and tell your side of the story. Again, document for your records who you have spoken to, when, what they said/did/did not do, etc. This will be your best defense. But I would call the BON and put them on notice of this co-worker’s behavior — it sounds extreme and dangerous. He has no business caring for patients when he is acting like this. Good luck!
I am a new nurse working for a home health agency and due to a personal emergency i was not able to make my shift today so I tried to call in, but I could not get through. The patients dad was with him all day today so the patient was not left alone. My manager did not care about my situation, but said if I am not able to come back to work tomorrow then the agency will lose the case and I will lose my job. Due to her not understanding and other previous issues, I would like to email a letter of immediate resignation. I still have a scheduled shift for tomorrow so If I resign today will I be reported for abandonment due to not being able to call off today and not coming for my shift tomorrow?
This is an employment matter, not abandonment. Unless you go in, accept an assignment, and leave without reporting or handing off care, it is not abandonment.
I took a PRN job through a temp agency. I have no experience and was told I would be trained. I went to the nursing home. They were mad the agency sent someone with no experience. They said they don’t train people, we are sent to step in. I should have been sent home but instead was asked to stay and I would have help. It is the ONLY reason I stayed. I had a 10 min orientation. I was told someone would be there to help me in a minute and to just do what I could. Long story short, I could not find anyone. I called and got no answer. I had no idea what I was doing, I was falling behind, loved ones were yelling at me, a patient was bleeding. I couldn’t find things. I was so mad and upset. I looked 3 different times for staff and found no one. I left. I felt like I was causing more harm than good. Hours later when someone finally realized I was gone. They called and said they were filing a complaint for abandonment. I am waiting on my hearing to be announced (it’s been a yr and 6 months since it happened) not sure if that’s good or bad. Regardless, I feel like she is the one who abandoned the patients and put their health at risk. She put her patients in an unsafe environment by having an untrained nurse alone. My lawyer has not spoken to me in over a year, no updates. When she was writing my statement she said it would look bad for me to file a complaint against her. I am asking your opinion on what I am looking at and what I can say in my hearing to help me.
Thanks!
Based only on what you’ve said here, first, I’m glad that you have a lawyer. Second, I wonder whether the board has finished the investigation and closed it out without letting you know? I would have thought you’d hear something by now.
Turning to the events themselves, I would have advised you to stay to the end of the shift, document everything afterwards, report to the agency about the events, and report the facility to the state licensing board for their conduct. Leaving as you did, if there was no one else around, was abandonment. I’m hoping those patients had someone else on that unit who took over. You accepted the assignment, even with conditions that the facility didn’t live up to. You had a professional obligation to stay until you could hand off care to the charge nurse or another licensed person.
Again, looking only at what you’ve stated here, a slightly mitigating factor is that you should never have been put in that situation, either by the facility or your agency. There were clear breakdowns in communication and a total lack of support for you. Having been in impossible situations myself, I do understand the frustration and fear, but leaving before ensuring continuing care is not professional behavior.
As for “looking bad” if you filed a complaint against the facility and nurse, that is a factor in the decision but not the deciding factor. The facility knowingly placed patients in jeopardy and a report was in order. At this point, I wouldn’t pursue it. I would, however, call your attorney back to ask for an update. If she has nothing to report, call the board and ask them the status of the matter. Ask them to let your attorney know, too.
Do you have any guidance for nurses who are working on call in procedural areas? I left a position by giving my director notice that I am resigning. Please note that there are other nurses available to work in this area who do not routinely take call but are qualified to. I have notified the physician on call and the paging office. My director has threatened to report to the TX BON for patient abandonment, and I feel this is an empty threat as there is no abandonment without a patient present. Please advise, and thank you!
If you had no patients, and there were others qualified to take call if needed, and you gave notice, this is an employment action, not abandonment. Your director will find that out with a call to the BON. You resigned, they need to find someone else to hire. That’s pretty straight forward.
I’m a new nurse in Texas. My first assignment off orientation was 8 patients with my charge nurse having 7 due to people calling In. In the future if I refuse the assignment due to it being unsafe can I just leave? If management is not willing to find additional personnel to help? Or do I just refuse the assignment and stay there?
I just saw your comment/question. Texas has a “safe harbor” provision — as far as I know, it is still the only state with such a rule. Go to this site: https://www.bon.texas.gov/forms_safe_harbor.asp and you’ll find the form and contact information it. This will tell you what to do, who to contact, the form to fill out, etc. Good luck!
In a perioperative settings what is patient abandonment? I was assigned to preop pt in the morning , I was on lunch break when I got in to a real emergency situation and in panic I could not notify the supervisor. At the time when I left I did not have any patient assigned, the unit was fully staffed, The patient was in surgery when I left. Apparently the supervisor accusing me of abandoning the patient, no written assignment was made by supervisor. Another nurse was assigned to the patient , After coming back I resumed the care of the patient whom they are accusing of abandonment. Is this real patient abandonement or employement issue?
This is an employment situation. When you completed your pre-op duties, you released the patient to the surgical team. There is no duty to care for the patient at this point because the patient isn’t “yours” once you turn them over to the surgical team. You didn’t “abandon” the patient in the legal sense. You did leave your patient care area for an emergency, while you had no assignment, and without notifying anyone — surely you could have told one of your co-workers or left a note, or called/texted at some point, but your supervisor could also have called/texted you, so the opportunity cuts both ways. It is, however, an employment issue to resolve, not patient abandonment.
I work home health . My patient also has a sibling who has a nurse as well. But we work different companies and she is not my patient’s nurse. When I get off of the night shift, there is no day nurse so the parent’s are to resume care. Recently they had a job change . They are asking me to resume care to the sibling’s nurse , because they will not be present. The only problem is , she is not my patient’s nurse and we do not work the same company. If I leave my patient in her care while she is caring for her patient , is that patient abandonment? Can I legally do that ?
First, let’s address abandonment. As long as you leave your patient in the capable care of either the parents or another nurse, you are not abandoning the patient. The problem comes with your employer, and that’s who needs to get involved in this. If the parents have to work, then they need to contract with one of the home care companies to provide continuing care for both patients. The issue isn’t abandonment, it is about the companies getting paid for nursing services. Let’s call your employer “company A” and the other nurse’s employer “company B.” I’m assuming that both companies bill Medicare or insurance for services that each nurse provides. The problem, as you spell it out, is that the parents want Company A’s nurse to provide care for the sibling after Company B’s nurse finishes his/her shift. Unless the parents contract with Company A to provide those services, Company A cannot bill insurance or the parents because they aren’t authorized to provide care. If the scenario were reversed for Company B, the result would be the same thing. You can’t provide services you are not contracted to perform. If something happens during an uncontracted period, the nurse would be personally liable and the company cannot pay you for uncontracted services.
The only solution is that the parents talk with Company A or Company B and arrange contracted services for the times needed. That way everyone is protected, covered, and paid.
Hi Bj, TN medical worker too. Huge question, if I was to come into my shift at 6pm like always, and no one showed up the shift before, so it was hectic. it was nothing but RNs. That being said they expected me (lpn) to come in at four and pass their meds, but i didnt wake up till 5 like i always do. so i get there, and not one med from the 4 oclocks got passed and now expect me to pass all of these. of course i did this, but them being there and refusing to give meds, wouldnt that be abandonment on their part?
To make sure I understand you correctly, you are an LPN and your shift begins at 1800. The day shift was short-staffed, due to what sounds like someone calling in or failing to show up. Those there were RNs. They wanted you to come in at 1600 to start early, pass meds. You didn’t get the message, woke at your normal time, arrived on time at 1800 to find that day shift had not given any of the meds due at 1600. They apparently left them for you to give, which you did. Your question: is this abandonment?
This does not meet the legal definition of abandonment. It DOES meet the definition of unprofessional and unsafe behavior. This incident must be reported to the risk manager and director of nursing ASAP. Patients were put in danger because these nurses failed to perform a key part of their duties. If any patient were to suffer harm because of this breach of care, it would fall squarely on those nurses’ shoulders. A jury and a board of nursing might even say it was gross negligence, which is a step above malpractice. You know you must give medications and give them on time. Knowing that and knowingly ignoring that responsibility is unprofessional behavior that endangers patient safety.
Report the facts as clearly and objectively as possible to your DON and risk manager within the next day or two, max. If nothing happens after a couple of weeks, consider filing a report with the BON. If this has happened before, it absolutely must be reported. Thank you for speaking up and for taking care of those patients!
Hi I currently work with a mobile app and I went to this facility I was working on one unit they wanted to remove me off another unit to place me on the Covid unit and I wasn’t found about that I said no so she was like I have no choice So I just left, I do work in South Carolina as a CNA she did text and said that she’s going to report me for abandonment
OK, I’m assuming this is a follow up to a comment above. If I understand you correctly, 1) you are not an RN or LPN; you are a CNA. 2) You were already working the shift with assigned patients when the person in charge said they were reassigning you to the COVID unit. 3) You refused the assignment. 4) Instead of staying and finishing the shift on the original unit where you had patients to care for, you left.
I can’t speak for what the SC boards will or won’t do. I can only give a general response. First, you aren’t licensed as an RN or LPN. States may or may not apply abandonment to CNAs; primarily it is unprofessional conduct for RNs and LPNs.
Second, I don’t know how SC regulates CNAs — in some states, they fall under the board of nursing. In other states, they are regulated by a different board or registry. You should call your regulating office in the state and speak to someone there about this incident to find out how they view it. Calling and talking to them won’t make your situation worse. It WILL give you some valuable information.
Third, even if the person in charge does report you to the regulating authority, it takes weeks or even months before anything happens. There must be an investigation and the authority has to talk with you, give you notice of what’s happening, and allow you to give your side of it before they decide what, if any, punishment is appropriate. They may say that this is an employment issue and is between the agency/app and the nursing home. Or they may say your conduct was wrong, in which case they can do anything from a reprimand to suspending your certification for several months, to revoking your certification. That would be up to them.
Hello, im a CNA in Michigan, I work at a small 35 bed facility. We have been having massive staffing shortages where there are holes and gaps in our schedules for weeks. i work 12 hours night shifts. now my question is, is it abandonment if i refuse to stay for open gaps in our schedule? on night shifts its two aides and 1 nurse, for day shifts its 2 nurses and 3 aides. Lets say 3 aides are suppose to be scheduled for mourning shift but on the day of there’s only 1 CNA that comes in and those open gaps where NOT filled by administration for weeks (no one picked up and its open positions) is it abandonment if i refuse to stay after completing my/a 12 or 8 hour SCHEDULED shift? those open gaps aren’t my responsibility right? I understand its a “work employment problem” Michigan is a at will state so corporations/employers can fire anyone for anything. but its the legal term “abandonment” being used as a threat to us that doesn’t sit well with us. thank you
I am an RN in NJ. Truly appreciate all the comments.
Nurses are being bullied, threatened and retaliated against by abusive nursing supervisors/managers regularly these days. To think these so called leaders are nurses with higher levels of education and experience and act like abusive controlling dictators, threatening their fellow nurses livelihoods, is reprehensible. I have been an RN for 30 years. I recently had a similar situation. I was working on my regularly assigned unit. I wasn’t feeling well that evening but carried on. The supervisor called and said after the oncoming shift arrives I must float to a different unit. I explained that I wasn’t feeling well and would need to use my sick leave. She immediately threatened me saying I was abandoning my patients she continued to yell and threaten and I said I’m not going to argue I don’t feel well. Many other nurses at my hospital have used their sick leave in this very same situation. Its stressful and can be dangerous as well. I called my union rep. and gave report to the oncoming nurses. I was about to leave and the union rep said I should not go and stay at work and even apologize to the supervisor. My jaw almost dropped. I knew I had done nothing wrong but I stayed and my colleague was nice enough to float in my place, since I was ill. I am now filing a complaint with the union and with the nursing board in NJ against this supervisor. They need to stop the bullying of nurses ! That supervisor never once considered my health or the safety of the patients I continued to care for while I was ill. I could have very well exposed patients to Omicron or something else. It is truly sad to see what is going on in the healthcare field. I came to find out the unit that she wanted me to go didnt even need any help at all.
I would be tempted to report this supervisor for unprofessional conduct — at the very least, make sure you document for yourself all the facts such as date, time, quotes, etc. Going through the union is a logical step and I hope they can resolve this to your (and other affected nurses) benefit.
Can a long term health care facility threaten to report a Certified Nurse Aide to the BON if they work their entire scheduled shift and refuse to stay after because the individual scheduled for the following shift called in or does not show up?
Sorry I guess the state of employment may help, the facility is located in Oklahoma. I’m posting for my wife as it seems to me that the threat of her losing her license over staffing issues beyond her control is an atrocious abuse of power by the DON and CNA supervisor. I personally have an Undergraduate in Health Care Administration, but have never practiced in the medical field other than as a CNA 22 years ago.
Regardless of state, no one should lose their certification or license because they refuse to work overtime, especially when it is unsafe for them to do so. While some states do recognize/allow mandatory overtime for RNs, reporting a refusal to work is not patient abandonment. It is an employment law issue, not grounds for disciplining a nurse or CNA’s license/registration/certification. And it would not happen overnight but would require an investigation with written notice to everyone and the opportunity to present their side/facts. Boards also do not like to get involved in employment issues so most likely they would refuse to pursue the claim. I hope your wife has calmer experiences after this!
I work for a start up Hospice as the director of nursing. The Administrator is the only other nurse on staff. We have a pt census of 4. We have both put in our resignations, providing 2 months notice. The owner is refusing to look for our replacements. Is it abandonment if we leave since there won’t be another nurse to provide care?
No. You are resigning with ample notice to your employer. You continue to provide care as you have until your last day. As a courtesy to the owner, in case they are in denial about your resignations, you can send an email one month out reminding them that your last day is the xxx and you’ll be sure to send a final status report on each patient before leaving. If there is an office, keys, files, whatever, ask how and where they want those items returned to them. That may spark some movement. But again, this is not abandonment by a legal definition. You might feel as though you’re leaving these patients in a rough spot, but the responsibility to bring on new people is your employer’s. Best wishes!
Hi i work as a contract nurse. I recently took an assignment working 2300-700. I took report for my unit and keys well 4 hours into my shift a cna notified me that another unit nurse never showed up and the previous nurse had left at her scheduled time so the unit was left without a nurse for 4 hours. Is it abandonment because i don’t want to pass meds on another unit when i never accepted the assignment. The 1500-2300 nurse just put her keys in the narc book and left.
I’m sorry this happened! The short answer, from a legal standpoint, would be that the incident should be investigated. The nurse who did not show up may or may not have called in, but because s/he didn’t take report and start caring for patients, there is no abandonment. The nurse who left the keys and walked off at the end of the shift with no nurse to assume responsibility — that is different. If that nurse notified the supervisor that they were leaving at the end of the shift, and the supervisor did nothing to provide coverage, then there is a problem.
If the nurse left at the end of the shift without telling the supervisor or any other nurses that the unit had only CNA coverage, THAT is abandonment. It sounds as though there are a lot of questions that need to be answered by an investigation. At the very least, this is a significant event that needs to be documented and reported to risk management and senior leadership. If something had happened to any patient, the facility likely would have faced serious legal and financial penalties. Even if all the patients were fine, this is still a major breach of patient care and safety that has to be fixed immediately.
Make sure you keep a copy of whatever incident report or memorandum you submit. Keep it factual, don’t speculate about motive or why someone did what they did. Note times and your response to the information. You did nothing wrong from the sounds of it. Others have some questions to answer.
I think that this would be an example of abandonment on the part of the 3-11 nurse who left 1) even though her replacement never came in, she left without notifying the other nurse that she was leaving or giving her report. The 3-11 nurse left the unit without licensed personnel for 4 hours and on top of that she left the keys to the cart in the narc book (which would include the key to the cart’s narc drawer)
Right, which is why I said what I did in the 2nd paragraph and why there needs to be an investigation. Both the facility and the BON need to know what happened and follow due process, interviewing everyone involved and getting the facts. Problem one is if the 3-11 nurse left without talking to anyone. If the 3-11 nurse did talk to a supervisor and was told to go ahead and leave, there are additional problems here. Thank you for commenting!
I work in a mental health crisis center that accepts patients who are in an immediate mental health crisis (think suicide ideation) or substance use withdrawal. At times I am asked to work virtually with another of our facilities that has no nurse present. When working virtually that includes triaging a client via telehealth and monitoring a med aide give medication. There are times when I do not have any clients at all in my facility. My question is two- fold. If I did not have any clients in any facility and I became ill and left in the middle of my shift after notifying my supervisor, would this be abandonment? What if I had no clients in my facility but had a client that I was “virtually” monitoring in another facility? Thank you in advance for your input.
Interesting questions — thanks for asking! The key to any claim of abandonment is walking away from patient care without letting someone know. Take an inanimate object as an example. You have a car, your name is on the title. You don’t want it or can’t take care of it (make payments, store it, insurance, etc.) anymore. You leave it somewhere, don’t tell anyone what you’re doing. You just walk away. Eventually someone notices and does something about the car. The point being, you left it with no intent to come back, and you didn’t tell anyone, “hey, here’s my car, would you keep an eye on it for me?”
With patients, there is a higher standard of care, obviously, since you have a life-and-death (potentially) situation. But the point remains, if you tell someone in the chain of command that you have to leave, that gives them (1) notice that you can’t take care of that patient right now, and (2) opportunity and a responsibility to find someone who can take care of that patient for now, until someone else can take over.
So if you are ill, have an emergency elsewhere, or some other reason or event makes it so you can’t care for or oversee that patient, you have a duty to let someone (a colleague or supervisor or other designated person of responsibility) know that. They in turn have a duty to work out care for that patient. This applies whether you are on the premises or virtually monitoring. It isn’t abandonment under those circumstances.
I hope this helps!
My shift is from 10pm to 6am. I am a caregiver at a memory care community. My question is if the next shift is no call no show, can I be reported for abandonment if I clock out at 6am when my shift is supposed to be over or am I obligated to stay and work another 8 hrs against my will?
I have a very important question if anyone can help. I am at my wits end and can not find any help at all. My mom was referred to a hospice agency about 2 months ago. They came out and assessed her, accepted her and started in home hospice. She got very sick and needed to go to the hospice facility and we found out that the closest one with that company was an hour and a half away. We took her but after her treatment was completed we asked to be transferred to a closer facility. There was no problem with the transfer and no discrepancies. Fast forward to July 13th, and the facility she was transferred to suddenly says they are dismissing her due to a medication discrepancy. Here is the problem….in ten years she has never taken her medication wrong. She was given a 10 day supply of medication on 6/23. She was dismissed on 7/13 due to supposedly being short on her medication but she should have ran out on 7/3 so how was she short? She did not run out of that medication until 7/18 so she made it last MUCH LONGER than it was supposed to. They won’t give me straight answers at all. This agency put her on the fentanyl patch as well as 1-2 oxycodone every 2 hours, then they suddenly dismiss her with absolutely no warning and leave her with one-two days worth of medication. I have been trying to find another hospice agency nonstop since then but everyone who comes out seems like they will accept her until they leave and get her records, then they say they can’t accept her. When I asked the prior agency what they put in her records to cause this, they told me that they wrote down that she left on her own free will…..they didn’t write down the medication discrepancy that they accused her of. Nothing makes sense at all. If that’s why they dismissed her then why are they saying she left on her own free will? What could they be saying to prevent other agencies from accepting her that they are denying? My mom is so sick right now from the agency suddenly stopping her medication, she can’t even keep ensure down. She is going to die a horrible death due to hospice making up lies about her. I took her to the hospital and they just sent her home. How can people have absolutely no compassion for a dying person? Isn’t this abandonment? Don’t they have an obligation to care for her until they replace her caregiver? I’m about to lose my mind, I cannot stand seeing my mom absolutely miserable like this and no person should ever have to go through this. This company should be ashamed to treat people like this. I have been very active in her care, as well as my brother and we both know without a doubt that she did not overtake her medication. How is this even legal?
I just saw your post. I’m so sorry you and your mother are going through this. The first contact should be your mother’s doctor. If she can’t keep anything down, she is in unstable condition and requires urgent treatment. Insist on it.
Second, I would take her back to the hospital and insist on admission for at least 24 hours. Your mother’s doctor should not agree to discharge as she is clearly not stable; discharging an unstable patient violates the Emergency Treatment and Active Labor Act (EMTALA), a federal law that’s been in effect since 1985. Hospitals and doctors can be hit with major fines for violating the law.
Third, hospices are regulated by the state and you can call the state department of health to find the correct office to report the primary hospice to. I get that providers are edgy about controlled substances but something is just not right here and should be investigated immediately.
You asked if this is abandonment. It isn’t from a nursing standpoint, but providers have to follow state guidelines when terminating care of a patient, and that means ensuring the patient has another provider to take over care, which clearly hasn’t happened.
Address the immediate needs of your mother first, then go through the state health department officials to get the situation properly investigated so it doesn’t happen again or to someone else.
Good luck and hopeful thoughts for you and your mother!
Hello I have a question. I am a manager in home health for a hospital. I don’t do any patient care and I work in the office. I recently turned in my resignation and gave them 3 week notice. Since I turned in resignation I have not been treated very well by my employer and it is now uncomfortable for me. Is it considered abandonment if I leave earlier than planned? Can employer report me to the board of nursing?
This is a great example of a strictly employment issue. No patient assignment, no walking off without notice. No abandonment. You’ve submitted your resignation. If you can hold on until the 3 weeks are up, obviously that’s more professional, but if working conditions are untenable or put you at risk of harm, then leave early. Use any leftover leave time, if you have any. If not, it is up to you. Good luck!
Thank you!
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Hi I currently work as a surgical tech but use my LVN license since my certified scrub tech license expired. I was scrubbed in, working for this surgeon for my first official shift. He was unprofessional, condescending, and has had assault accusations against him from a previous scrub tech. Anyways half way thru the surgery he told me to go take a break and eat so I did and I didn’t come.back. I let the manager know via text I wouldn’t be coming back. Mind you he has a RN who could take my place as a scrub since she scrubs for him when he has no one else. There are 2 other doctors in there w this patient who is fine and stable. I was reported to the board and they said something COULD have happened to the patient and are accusing me of not telling the manager until an hour later but that wasn’t the case. I have a lawyer but she is horrible and not helpful whatsoever. I wasn’t working as. A nurse nor would I ever leave a patient alone completely. Thoughts?
OK, let’s break this down. You were working under your LPN license, in the OR, as part of a team performing surgery on a patient. When the surgeon told you to take a break, you did but you did not go back. You did tell your manager at some disputed point in time after you left the OR. There were at least three other people in the OR when you left and the patient was stable. Presumably someone took over your scrub tech duties while you were at lunch. Surgeon has history of problem behavior and apparently was displaying more of the same while you worked. You were reported to the BON for abandonment, don’t like your attorney, This is what I’m getting from your comments.
How a reasonable manager and Board would look at this: You are an LPN and were in the OR because you have a valid LPN license and could perform the duties of a scrub tech/nurse. The surgeon misbehaved (separate issue for the hospital and his board to deal with.) He told you to take a meal break. You did NOT tell him or anyone else on the team that you weren’t coming back, either at the time you left or after you left the room. You did tell your manager by text. We don’t know when she got that, when she notified the surgeon/team, who else was actually available to step in. So we have a patient under anesthesia, open incision, on the table mid-procedure, stable at least up until the moment you left. But you didn’t come back. Nothing happened, but it certainly could have. You were part of a TEAM and you chose not to continue doing your part of the procedure.
So yes, I can see how a board would argue that this was abandonment, or, at the very least, within a millimeter of it. What should you have done? Notified your manager of the surgeon’s conduct and ask for someone to replace you, AND THEN RETURNED until a replacement showed up. Abandonment means walking away from your assignment without advance notice and proper handoff to someone who takes over your assignment. Justified or not in this case, it sounds like what you did, based on the above.
As for your attorney being “horrible and not helpful”, this is something you need to talk to her about — calmly, objectively, asking questions about why she says this or advises that. You can change attorneys if communication is so broken between you.
What will the board do? I don’t know. At the very least, I suspect, they will issue a reprimand. What will your facility do? That is between you and your manager/HR/Department of Nursing. Own your behavior and accept the consequences. Learn from it.
I do recommend objectively and thoroughly documenting the surgeon’s words and behavior and reporting him to the medical director of the hospital and possibly the Board of Medicine in your state. Keep words like “condescending” out of it. Be factual. You should not look to justify your own behavior or shift blame. His conduct was enough to push you and others away and needs to be documented for his own and his patients’ benefit.
Good luck.
I am an LPN in Pennsylvania. I was scheduled to work as an LPN. After clocking in, getting report, and while counting narcotics; per diem RN arrives at facility yelling at me to stop counting because she is working as an LPN and I am working as an aid. I am not qualified as a CNA. I spoke to previous shift supervisor and explained that I did not pick up as a CNA and that I was leaving. Is this abandonment?
If you didn’t already have an assignment, then no, it isn’t abandonment. This sounds like a scheduling issue since you were being asked to do something you aren’t slotted for. I doubt they would have paid you as an LPN for CNA work, so I wonder if it was just a way to get more skilled coverage at a lower rate of pay.
As a physician who relies on my staff showing up to provide care, it should be abandonment. You know you are suppose to be there to provide care. If I am on call and refuse to see a patient, that is exactly what I face. When a healthcare provider, voluntarily agrees to work, they should show up, unless valid excuse. Since COVID, nurses have become unreliable, and to the point of unethical. Quitting without notice, moving on to the next job, leaving their co workers, and especially leaving patients at risk. If you do not want to accept that obligation, do not work in healthcare.
I agree with what you’re saying. You were assigned to do your job. If you did not do your job then yes it would be abandonment. My job coming on shift was to be an LPN and to do my duties as such. Part of my job is to assist CNA’s when they need help. I was told to be a CNA and to do the duties of a CNA after clocking in. I am not qualified as a CNA. I appreciate both replies.
On nights I’m the only RN on unit and the only way I get breaks or can leave is if I’m relieved by another RN such as house supervisor or they can send a RN from another unit to relieve me. Well I have been having issues with getting breaks which I addressed with the manager and was told to tell the supervisor it’s policy that I get a 30 min break. I was working a 7 night stretch on night number 6 and again supervisor informed me she could not cover my break and I informed her it was policy. She then left the unit and I started getting sicker (even had OTC medication delivered to the hospital for me and also my toddler had been diagnosed with RSV the day before) and decided I was too sick to stay and called supervisor to tell her and she would not answer the phone (it’s a cell phone kept on supervisor whole shift for all units to reach them on) she never returned my call either so I messaged manager told him I was sick and done to find someone to come in for me because I needed relief and would not be returning due to issues with Supervisor. I even messaged a day shift nurse about coming in early. Well later supervisor did come back to the unit I then had her to waste a half of a narcotic with me that I had to give patient a half of. After finishing that I left supervisor with written report sheet on all patients and took my bag and clocked out and left. Now being threatened with abandonment. All involved are saying no one knew I was leaving and not returning. Thoughts and Thank You
There are a couple of issues here. First, no abandonment by legal definition. You made multiple reasonable efforts to get coverage, gave report, told them your status. If you haven’t already, write a memorandum for record for your personal files with date, times in order of events (what happened, when it happened, how you responded, who you contacted & when, what they said/did — quotes are best.) Don’t include subjective terms such as “she argued with me.” State what was said and how the person acted, and state what you said and did. Keep this in a safe place. You can also send a copy to HR. If the Board of Nursing contacts you, you’ll have everything you need to answer their questions.
The second issue is the problem of no breaks. Several groups of nurses have filed lawsuits against facilities for violating federal and state labor rules. In most states, employees who work more than a certain number of hours MUST be given breaks OR paid for the time. Several of these suits have been successful lately and state departments of labor are cracking down on employers who fail to follow state laws and regulations — fines and penalties result. Document the times you’ve had to work without a break. Other nurses may want to join you in reporting the facility to the state’s department of labor or the federal DOL. Your state nurses’ association may be a good resource for information on this issue too.
The third issue is patient safety. If you are forced to work while ill, that puts patients at risk and the facility at risk too if they knew but did nothing to get you out of there and away from patients. You may consider notifying your facility’s risk manager.
Best wishes!
The BON just contacted me by email doing an investigation. I’m worried are you licensed in WY or know of a good attorney in WY to help with this that I could hire?
First of all, they are only at the investigation stage and many times, once all the facts are collected and reviewed, the case is closed with no further action. However, it is a good idea to at least talk with an attorney before you get too far into the situation.
I am not licensed in WY but there are attorneys who can assist you. Your best bet is someone in Cheyenne, the state capital, which is where the BON is located. If you have your own nursing professional liability insurance, contact them first to see what they advise and if they have a list of attorneys that they refer nurses to. For example, Nurses Service Organization’s policy has a nursing license defense benefit that pays up to a specific amount in legal costs as part of its coverage.
If you do not have your own policy, you can locate an attorney through a couple of websites. One is lawyers.com, a national database of lawyers/firms. Search by location (Cheyenne) and subject matter (health care law). There are a number of attorneys and firms that are listed. Call several and get a feel for who handles license investigations, disciplinary actions, etc.
The other website is martindale.com, which is another national directory of attorneys (they used to maintain a comprehensive print version that most libraries stocked in the days before the Internet.) Narrow your search using the options on the left side of the screen. You’ll see similar names from the lawyers.com site. Martindale is a bit more ratings focused. Both should give you names, contact information, etc.
Remember that nothing happens without you having the opportunity to state your facts and to be heard by the BON, and it takes time to follow procedures. I do strongly encourage nurses to at least talk with an attorney before doing anything involving a BON investigation, and definitely if you are notified of a hearing before the board. Good luck!
So many slack jawed supervisors use the false definition of abandonment as a threat to staff nurses, it should be punishable for making threats against your license like that considering the effort and resources it takes to defend your license against *actual* threats.
Hello,
I am a nursing student. My school is trying to fail me from my current clinical rotation and lecture class due to patient abandonment. I gave proper handoff report to the RN that was sharing the patient with me for that day, as well as notified my clinical instructor as to when I was leaving the floor. They claimed that we are only allowed 30 minute lunch breaks, but there is nothing in our student handbook about that and I was not told how long our lunch break would be. In addition to that, I have always taken hour lunch breaks throughout every clinical rotation I have had in the past. I am wondering if it is even possible that a student is failed out of a class/clinical for something like this.
I’m sorry to hear you are going through this. First, based solely on what you’ve said here, this would not meet the legal definition of abandonment. However, you’re not a licensed RN yet, so this isn’t a Board of Nursing issue. This is a college/university education issue. Having taught for several programs over the last 30+ years and read a number of court cases involving students and universities, I can tell you that universities can set their own rules. As long as they do not violate state or federal laws, they can set whatever criteria they want for classes. It may not be fair, but the school holds the upper hand here.
My suggestion is that you talk to the assistant dean or dean of the program. Stay calm, objective, don’t whine. Review the facts: you and your classmates have had 1-hour lunch breaks in all previous clinicals. There is nothing in the student handbook that says otherwise. Your instructor did not tell you lunch was 30 minutes. You followed procedure to hand off care of your patient during lunch. Your research indicates that the definition of patient abandonment is leaving without reporting off or handing off care to a qualified nurse. Suggest respectfully that your conduct in handing off care does not meet that definition, that you regret not knowing this clinical instructor’s time allowance for lunch. Ask to be allowed to finish the semester (sooooo close to the end!) and what remedy would satisfy the dean. Go from there. That’s about all you can do. I hope it works. Good luck! (And for the future, never assume a 1-hour lunch break — those are pretty much unheard of in the schools I’ve taught in, and definitely won’t happen when you start practicing. Thirty minutes IF you are lucky.)
Hello from Illinois. Myself and a coworker have been wrongfully terminated twice in the past 7 months. We recently returned to work on May 15th, 2023. Since returning to work, Public Health has entered the building and investigated us because the facility’s management sent in a false report stating we had neglected a resident. The management of the facility was the one that called the state and turned in a couple of different complaints. We were told before returning to work that the management would be replaced, but they have not been. This last Friday, May 19th, 2023 I was told by the care plan coordinator that she was asked to come to tell me I was being mandated to stay over my 8 hours. I usually would not have a problem with this, but I refused to stay since it’s been a very hostile work environment since I returned to work. From snarky comments, talking about me at the nurse’s desk, dirty looks, etc. Now they are saying I am probably going to get fired again for job abandonment. My question is can they do this? Is it really job abandonment because I refused to be mandated? I had worked my 8 hours I just refused to put myself in a position of being there more than I had to. I was scheduled for an 8-hour shift. Yes, we can be mandated, but they could have mandated someone else besides me. The facility that I work at is also Union. All my troubles started last May when I became a Union Steward.
I am so sorry you are dealing with this. You raise two issues here. To answer your question about abandonment, as I said in the original post, there is a difference between abandoning patients and refusing an assignment. The board of nursing would take action for abandoning patients (as defined in the article). Refusing an assignment is not patient abandonment. However, it is an employment issue and IL employers can fire employees under the “at-will” employment doctrine, which means the employer can fire for good reason, bad reason, or no reason.
That said, however, you allude to the second issue, which is employer discrimination or action against unionized workers or union activity. That violates federal law and your union headquarters should have an attorney who can raise this issue for you. You can also contact the US Department of Labor about local representation. Employers can be fined for anti-union activity, even threats of discharge under the pretense of “abandoning” patients. I just saw a news item about IL voters approving the Workers’ Rights Amendment to the state constitution last November, which adds protections to workers under collective bargaining provisions. I haven’t read the amendment and am not licensed in IL so you’ll need to talk to a labor law attorney for details. Good luck!
Hello, I am a 30 year plus RN working in the PACU. Recently a per diem RN handed off her unstable critical care patient to me while she went on a 30 minute break. She did not return for 90 minutes. When she did return I questioned where she had been, she said that when she left she ran into the “charge nurse “ who told her to go on her break and lunch together. I asked her why she didn’t inform me of this, she shrugged her shoulders and said, “because I was on break” Does this constitute patient abandonment, as she handed the patient off for an agreed 30 minutes but took 90 minutes without further communication ?
The “charge nurse” was also taking a 90 minute break at the same time, which is against the rules. I also received a contact isolation patient 5 minutes into covering this supposed 30 minute break which the charge knew I would be getting. I have expressed my concern about this charge nurse to my supervisor 3 times since this incident stating that I don’t feel safe with her being in charge and that she is “weaponizing “ the position of charge nurse, yet she still receives the assignment of charge nurse. The only ramifications from this incident that I am aware of is that she’s no longer allowed to combined her lunch and break, which she wasn’t allowed to do in the first place. Can you provide any guidance regarding this situation?
Apologies for not answering sooner! From a strict legal perspective (as in, could I walk into court and prove abandonment by legal definition), I’d say she is skating on very thin ice. I know of no healthcare facility where hour-long breaks or meal breaks are the norm, let alone combining a break and a meal. Not telling you? That’s unacceptable from a nurse leader point of view. Coming at this from a risk manager perspective or a plaintiff’s attorney perspective (I’ve been both in the past), if something were to happen to this nurse’s patient(s) that could be construed as unsafe practice or malpractice, as a plaintiff’s attorney, I would not hesitate to name the nurse and the charge nurse in the complaint, and I could readily find experts who would testify that this behavior is not the standard of care for these nurses/positions. Were I the supervisor or director of nursing, I’d have had a serious discussion with these individuals before now. Guidance to you? Document every incident for your own records — date, time, patient status, who you talked to, etc. I hope you never need the information, but it could be necessary. Good luck!
I was working as a Psych NP at a mental health clinic and I put in my two weeks’ notice to my supervisor and clinic manager and I have sent a copy to myself as well. Today, I had a meeting with my supervisor, regional supervisor, and her boss and was told that in my contract I have to give a 60-day notice. I was unable to give a 60 day and they threatened me with the inability to let patients know I am leaving in 2 weeks and they will report me to the BON of GA for abandonment. I told them I would send out a letter as well as address the patients with a call about my leaving. My question is this patient abandonment?
Quitting your job is not patient abandonment unless you walk out in the middle of a shift without notifying anyone or handing off care. You are quitting. You’ve given notice to your employer and supervisor. Is that sufficient notice under the terms of your contract? That is an employment question, not patient abandonment under the legal definition of the word.
I recommend you 1) reread your contract to see if it does require 60 days. Since you say you can’t do that, this is still an employment law/contract law problem, not patient abandonment. Your employer has an obligation to arrange coverage for patients.
2) Contact the GA Board of Nursing and talk with someone there about what your employer and supervisor have said they will/won’t do. They should not block you from notifying patients of your departure and they should notify patients themselves, especially if appointments need to be rescheduled or shifted to another provider. I don’t know what GA requirements for leaving a practice are, but their definition of abandonment is the same as other states. If your employer were to file a complaint of abandonment, the BON will investigate because it has to, but close the file if it doesn’t find true abandonment.
3) Notify your malpractice insurance carrier and discuss with them about what, if any, additional steps you should take to protect against a possible threat.
Good luck!
Abandonment: What It Is And Is Not
Abandonment is a concept that evokes strong emotions and conjures up images of loneliness and neglect. It’s a term often used in various contexts, from relationships to property, but what does it truly entail? In this exploration, we’ll delve into what abandonment is and what it is not.
Abandonment IS a conscious act of desertion or neglect. It occurs when someone intentionally leaves behind a person, place, or responsibility without regard for the consequences. This can manifest in various ways, such as a parent leaving their child without proper care or a partner abruptly ending a relationship without explanation or support.
Abandonment IS NOT always a deliberate action. Sometimes, it can stem from circumstances beyond one’s control. For instance, a person may need to relocate for a job or face a sudden illness that prevents them from fulfilling their obligations. In such cases, it’s important to distinguish between abandonment and unavoidable life changes.
Abandonment IS an emotional experience. When individuals feel abandoned, they often experience feelings of rejection, sadness, and loneliness. These emotions can have a profound impact on mental health and well-being, making it crucial to address the emotional fallout of abandonment.
Abandonment IS NOT synonymous with independence. Choosing to pursue one’s goals or live independently does not equate to abandonment. Healthy relationships and personal growth can coexist without leaving others feeling deserted. It’s essential to strike a balance between personal autonomy and maintaining meaningful connections.
Abandonment IS a complex issue. It can have far-reaching consequences, particularly in childhood, where it can shape a person’s self-esteem and interpersonal relationships. Recognizing and addressing the effects of abandonment, whether through therapy or support networks, is vital to healing and personal growth.
Abandonment IS NOT always permanent. People and situations can change. Relationships that experience abandonment can be rebuilt with open communication, understanding, and effort. Similarly, property or possessions left behind can often be retrieved or replaced.
Abandonment IS a concept that varies across cultures and individuals. What one person considers abandonment may not be perceived the same way by another. It’s crucial to acknowledge these differences and engage in open dialogue to ensure mutual understanding and respect.
In conclusion, abandonment is a multifaceted concept that encompasses deliberate actions, emotional experiences, and life circumstances. It is not always a negative or irreversible situation, but it can have significant and lasting effects on individuals and relationships. Understanding what abandonment is and what it is not is essential for fostering empathy, healthy relationships, and personal growth.