"Abandonment"

[erkantarik]

I need advice on how to deal with a situation occuring in a hospital setting, with a final semester nursing student in an AD program.

This student nurse was assigned a stable patient. The clinical instructor had found out that the client had a spouse who was also a patient on another unit (ICU). The instructor indicated to the student that "it would be nice" to allow the stable client to visit his spouse. The student nurse, on that statement" accompanied the client, in a wheelchair, to visit with his spouse. Staying there with the patient, the patient said to the student, "We're OK. Would you please leave us alone for a little while?"

Deferring to these two patients' wishes, the student nurse left for about 5 minutes to use the toilet.

Upon returning to the two patients, the student nurse returned the "visiting patient" to his unit.

The student nurse, when getting a final evaluation was told that due to "abandonment" he was to fail the clinical for the semester and of course would not graduate.

Any ideas or suggestions on this matter? Does this actually fit the definition of "abandonment" and if so why was the student nurse not discuplined at the time of the incident.

Can attorneys get involved in matters such as these?

Thanks so much for your help.

[nurse_wannabe]

You know, nursing instructors really amaze me with their power trips sometimes. This is just completely ridiculous. What is the harm in leaving someone to visit with their loved ones in private for 5 minutes? I guarantee you that if this nursing student had been one of their favorite pets, nothing would have been said. In fact, he would probably have been fawned over for being so compassionate. :angryfire

Leaving the room for 5 minutes is not patient abandonment. Period.

Just curious, though. If he was only gone 5 minutes, how did the instructor even find out?

[Katnip, RN]

Check with your BON on their official definition of abandonment.

In general, it means that once you take report on a patient, you assume their care. Abandonment means that you stop assuming the care of the patient without making sure another nurse takes care of the patient.

Leaving someone for a few minutes while the patient is visiting and while the caregiver goes to the bathroom does not constitute abandonment IMO. Few nurses, if ever never leave a patient's bedside.

[DusktilDawn]

What you described by no means fits the defination of abandonment. Are you sure there is not more to this story?

For instance was this his only patient? If he had another patient assigned to him and left the unit without informing anyone or arranging for someone to cover for him while he was gone, I can see abandonment being an issue.

Did he inform anyone he was leaving with the patient? Although this would not be abandonment, it could be an issue.

If the staff was aware that the patient was being taken of the unit to visit his spouse accompanied by the student, if the student did not have another patient assigned to him (or if he did he arranged to have someone cover for that patient while he was gone), I don't understand why any instructor would fail him for abandonment. I also agree that if there were any issues from this event they should have been addressed at that time.

There may be recourse within the school for this student to appeal the decision made by this instructor. He could start by speaking with the dean of nursing about this matter.

[Tweety, BSN, RN]

Oh for heaven's sake. Now I've heard it all.

[SophiaRN]

I think there must be more to this story! As described, in no way does this constitute abandonment IMO.

[elkpark]

I can see possibly talking about abandonment IF we're talking about a situation in which the student had more than one assigned patient (which I would hope he would, in the final clinical rotation of a nursing program!) AND left his assigned unit for an unspecified amount of time without informing others and making arrangements for another student/nurse to cover his other patients while he was gone. That would clearly be irresponsible and inappropriate.

Is it possible that the "abandonment" issue refers to abandoning other assigned patients, rather than the one patient who was escorted to ICU?

Yes, it would be nice if this had been addressed at the time the incident occurred, and, at this point, it can't hurt to pursue whatever grievance resolution procedure the school offers

[erkantarik]

Sophia, there is nothing more to this story than the fact that this clinical instructor has been trying to sink this student throughout the entire semester. The student was seen on his patient's original unit after coming out of the restroom. This was the only patient that was assigned to this student; no one is citing him on anything else than leaving this patient unattended for the time to go to the restroom (maybe 5 mins.) Unfortunately, he did not indicate to the spouse's primary nurse that his client would be staying alone with his wife; the wife's primary nurse was not in sight when he left the two patients alone, as their request. Ideally, he should have notified someone in the wife's ICU that the husband was going to be left alone with the ICU wife for the lenght of time to use the restroom. And to think, that this was the primary basis of flunking this student for the semester in the clinical component and failing to allow him to graduate. So much for the nursing crisis and getting competent nurses into the workplace!!

[Homecare Worker]

Ideally, he should have notified someone in the wife's ICU

Ideally?!

Isn't it a breach of security?

Imagine the surprise of the ICU nurse to discover someone unknown, unexpected and unattended, at the bedside of a critical patient.

I'll bet her/his heart skipped a beat.

[babynurselsa, RN]

BReach of security? This is not a locked down NGRI unit it is an ICU with visiting hours. If the wife is in ICU and the husband is also inpatient then I am sure that info is passed in report.

If this patient is on a general medical floor and goes to see his wife in the ICU I cannot personally find a rationale why they could not be alone for a minute.

I would reguest a meeting with faculty and file an appeal.

[Antikigirl, ASN, RN]

That is beyond rediculous! Yes, I would have notified the RN in the ICU of the patient being in the room, but a moment to go to the bathroom! Please...I would get 'patient abandoment' charges all the time with my coffee intake! LOL!

No, it was by the request of the PATIENT that he be left alone with his wife for a moment...that is within the patients rights! If he is able to make sound medical judgement for himself and is in no danger of harming self or others...he has the right to decline a nurses presence in the room for some privacy!!!!!!!

So this is also a Patient Rights deal if the patient was fit to make choices on their own!

[sacralciara]

When I read the scenario I picked up on two things:

1) The instructor suggested this visit, then failed the student because of "abandonment". I smell setup. What remains unclear is who was the abandoned pt? The transported one or another pt the student may have been responsible for?

2) If abandonment was related to the transported pt, then I agree with others, the student was simply respecting the pts request for privacy and fight the decision. It might save another student nurse from being victimized this way down the road.

Ciara