Is it legal for a nurse to work 24 hours straight?

Nurses General Nursing

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Im so upset. I need some opinions and to vent...............

I work in home health and I have a client that has 24 hour nursing care. I was scheduled yesterday to work 7a-7p. At 4pm my patient was in the hospital with a fever. My on-call supervisor had instructed me to stay with the patient and if the patient was admitted I was to go home. He also said if the patient was released I was to call him so he could call the next nurse (who was on standby) to come in and take over. My patient was cleared to go home at 10pm (afebrile, all blood work normal). I called my supervisor and he said ok I will call the next nurse and call you back. He called back 20 minutes later and said she's not answering. You will have to stay until I can get a hold of her. Her shift is 7p-7a. He never got ahold of her and I told him he needed to try to get someone to come in and I asked him if they were going to seriously make me work 24 hours. He basiclly told me I couldnt leave (I wouldn't anyways because of legal issues). So I stayed with my patient until 7am the next day. My supervisor had told me I can't find someone to come in. I was soooo mad at him.....for putting not only my patients safety at risk but also my lisence.

Should I report this to my main office? Is this even legal for them to not only put their employees in such conditions but putting the clients at risk. And this was an infant client that was on 24 hour 02, had a trach and a feeding tube and was on dialysis 13 hours a day. The client required alot of attention and needs a nurse who is I just can't believe they think that is ok.

I hope this wasn't too confusing. Please give me your opinions and advice!!! :twocents:

Specializes in ICU, Telemetry.

1) I'd be willing to bet that the next nurse had already called out, that's why he told the OP to stay.

2) There have been volumes of studies that state working more than 11 hours dramatically increases the risk for error and employee injury. I wouldn't even do 16 unless we were having a disaster.

3) Your boss will probably throw "So you were going to abandon your patient?" at you. That's why you call your BON before you talk with him, so that when he brings this up, you tell him you discussed "unsafe working conditions" and "illegally mandated amount of continuous hours" right back at him.

And you really need to go find another job if you can. He's a snake.

Specializes in PICU, Sedation/Radiology, PACU.
You would have been leaving him with a nurse----at the hospital!!! Sounds like your supervisor is a real piece of work....

Unless the patient is admitted to the hospital, the home health company still has responsibility for the patient. That's the law. If your child is admitted to the hospital, you might leave them alone in the room, but I certainly hope you wouldn't leave them alone in a doctor's office, walk-in clinic, or an ER just because another nurse was there! Her supervisor was correct on this. What in the world was the ER nurse supposed to do with the child once he was able to be discharged and no one was there with him?

Personally, I wouldn't have done it because I know I would not have been capable of practicing safely. Just because it would be legal for me to work 24 hours doesn't mean I wouldn't be putting my license at risk by doing so.

I agree that it's not safe and shouldn't be done. However, it doesn't look like the OP had any choice. If she had refused to work and had left, she would have been guilty of patient abandonment. That would put your license at risk even more than working 24 hours straight.

1) 3) Your boss will probably throw "So you were going to abandon your patient?" at you. That's why you call your BON before you talk with him, so that when he brings this up, you tell him you discussed "unsafe working conditions" and "illegally mandated amount of continuous hours" right back at him.

Good thought, but I highly, highly doubt that a representative from the BON would have been available at 10pm to discuss this issue with the OP. I also think that, had the OP just left the patient, she legally could have been sued for abandonment, regardless of the circumstances.

OP, you made the right decision by staying and working. There really wasn't anything else that you could have done at that point. However, like I said early, definately complain up the chain of command and figure out what policies (or non-policies) led to this situation. Clearly your facility needs an emergency on-call system for situations like this. And absolutely, if your supervisor is an RN, than he should have been the one to come in and relieve you.

The error here lies in not being relieved at 7pm. Period. Where was that nurse??? And if the pt had been admitted who was going to do all that care?!!

And if you had been scheduled to work the next day, what would have happened? BTW, who eventually relieved you?

This was not an emergency situation, and the 7p nurse should have relieved you. It was not your responsibility to stay indefinitely.

Best wishes in your next job.

Duhhh? Check out with the Labor Laws in your state. Start looking for new employment . And foremost do NOT let anyone intimidate you. YOU need to take care of you. Keep us updated. Thank you

Oh and another thing, It is your license on the line. If something went wrong with that patient, guess what, you were working!!

My employer had told me that I could not leave until he was admitted. Which I didn't understand. I also did all his suctioning and feedings/meds while he was in the hospital. The hospital staff and my employer told me I was to do his care until he was admitted. This whole thing was a mess. I was under the impression that I could not leave my patient unless he was admitted. My supervisor did not care about my patients safety or me at all.

oh I don't like this.

YOU were basically caring for this client while he was waiting for a bed? OR was he in the ED lobby waiting to be initially assessed and POSSIBLY admitted/given care?

If your in the Lobby...I would say..yes, you give care.

Once hospital personel has assessed the pt and decided that additional care is needed...your done.

I would think that the hospital would want it that way as well...as too many cooks can spoil the stew..so to speak and only one entity needs to be responsible for care...the hospital.

as for the 24 hrs.

I don't think it's very nice that your supervisor treated you this way. I understand that you didn't want to leave and I too would be concerned about pt abandonment issues...

however...what happened to your replacement? I would hope that she is no longer employed. If your on call..your just that..ON CALL. If you are scheduled for a shift...then she should have been waiting for that call to come to work..not just gone on and made other plans. If anyone abandoned a pt it was her. She has a responsibility to be available when she is on call.

What would have happened if the NEXT shift..hadn't shown...would you have been told to stay? I mean you've already done 24hrs what's another 12 right??? :confused:

CRAZY!

You need to have a heart to heart with your manager and ask for some clarification in what SHOULD have occured v what actually did...and what steps are in place to keep it from occuring again.

PS: I would INSIST on additional compensation for those hours...I just don't like that they forced you into a potentially unsafe situation...and they should apologize and make it right by compensating you for your time over and beyond your scheduled duty.

I had this happen to me...several times. I simply told the agency that I would be sleeping as there was also a CNA on duty. The pts mom agreed to come in and stay for a few hours while I got some light sleep. There's no way you could have sound mind and judgement working 24 hours straight. Yes, I did get paid for the few hours I slept.

Specializes in OB, ER.

That is horrible and I hope it's not a regular occurance.

I am and ER nurse and I do appreciate the staff staying with patients in the ER. The ER a lot different then being admited. We don't have time to do tube feedings and such. We don't know the childs routine and equipment. Plus the biggest thing is we can't stay with them 24/7. It is not a secure enviornment with locked doors or alarm bracelets. The ER is VERY unsecure and can be quite dangerous. We never let a parent leave a child alone even to go to the cafeteria. It's just not safe. The floor is much better equipt to deal with the day to day tasks of a sick child.

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