Originally Posted by prn nurse
I'd like to get your input. Two ICU R.N.'s at our hospital left work in the middle of their shift to go shopping at a nearby mall. They were gone for two hours. (Did not clock out..or back in.) They did not ask/tell the supervisor. One nurse had an aide "cover" her patients for her while she was gone. The other nurse had another R.N. cover her two pts. while she was gone. The remaining R.N.'s on the unit were unaware of what was taking place...the 2 nurses worked two different units...weren't really missed...simply assumed to be taking a long lunch. In your opinion, how should management handle this? What would happen in your hospital?
There are a few concerns here. Each State defines what "abandonment" means for that State. Most States adopt the Federal Standard. I'm running on memory now so this is not word for word by any means. It is posted on the net. Just Google search it. Once a nurse accepts care for a patient they "contract" to care for that patient in the normal standards accepted in that State. In your case, my opinion is that the aid is not qualified to care for ICU patients anad that nurse is guilty of patient abandonment. As to the second nurse who had nurse care for her patients, that is full time work so they could not be caring for their other patient load while constanatly monitoring the ICU patients! If she went to care for her own patients, she could not be monitoring the ICU patients. She or he may be guilty of patient abandonment by accepting responisibility for two ICU patients. You can't do them both. As to punishment, depending on what happened with the RN who accepted the care if the patients, she should be reprimanded and a note made in her file if she ever wanted a recommendation.
The RN who let an aid cover for her should be fired. The fact that these patients were in ICU means they demand the highest quality of care that can be given. They are in life or death status. If one died or an incident happened that led to their death, the hospital would be sued, their insurance would skyrocket and it sets an example to all the Staff. If they had informed their immediate supervisor, in any State, they are off the hook and the supervisor's head is on the block. The little things that would make the difference is whether the patient load was so light there were nurses with nothing to do so one actually could cover for one of the nurses. In any event, they should both be docked pay for time not on the job. The Nursing Board for your State would likely suspend the license of the nurse who left an aid to care for her patients and the aid as well for taking on a medical practice she was not licensed or qualified to do.
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If for nothing more than taking a two hour lunchbreak, for goodness sake! It doesn't matter WHAT they did on their lunchbreak, the problem is the time span they were gone, unless that time was pre-approved by Nursing management. NOT! 
Possibilities
