Abandoned patients 2 hours before end of shift

[Nurse Beth, MSN]

Being micromanaged and bullied takes a toll on your mental health, and it's concerning that it led to a situation where you felt you had no choice but to leave.

The key to moving forward is to be honest, transparent, and proactive in handling the situation. Understandably, you were under stress, but showing that you take responsibility and professionally working through this will help you in the long term.

Patient Abandonment

The American Nurses Association (ANA) defines patient abandonment as "a unilateral severance of the established nurse-patient relationship without giving reasonable notice to the appropriate person so that arrangements can be made for the continuation of nursing care by others…" 

Patient abandonment is a breach of the ethical and legal duty of care.

However, if you gave report and turned over the care of your patients to another RN capable of providing care, this will not be considered patient abandonment, just job abandonment. It sounds like you and the charge RN were responsible for the whole unit, and you were only a "support RN." If the unit was adequately staffed without you, and there were no immediate risks to patients, this could mitigate the allegations.

If you believe there was no immediate danger to patients when you left (especially if the charge RN was still there), note this in your defense.

Board of Nursing

Dealing with the Board of Registered Nursing (BRN) can be stressful, but it's important to take steps to protect yourself and your professional reputation. Here's a course of action you can take to prepare:

• Document everything. Details of the incident- write a clear, objective account of what happened on the day of the incident. Include the timeline of events, how you were treated, any interactions with your nurse manager, and your state of mind. Be sure to include why you felt that leaving the shift was necessary for your mental health and perhaps even your ability to provide care.
• Communication. Save any written communication, such as emails, texts, or notes that pertain to the bullying or micromanagement, and any documentation related to your resignation.
• Witnesses. If any colleagues witnessed the behavior or your actions during the shift, contact them to see if they'd be willing to support your version of events. This can be helpful if the BRN requests further information.

Review Your Employee Handbook & Company Policies

• Understand your employer's policies around resignation, leaving during a shift, and patient abandonment. This helps assess the severity of the issue and whether your actions violated their policies.
• Check if your employer has any procedures for handling bullying or harassment.  You may be asked if you followed any such procedures.

Consult with an Attorney

Given that you may face a report to the BRN, it is a good idea to consult with a nurse attorney with BRN experience in your state. Check the American Association of Nurse Attorneys to find an attorney.

An attorney can help you prepare a statement or defense to present to the BRN and advise you on the potential outcomes or consequences of the BRN investigation.

Prepare Your Response to the BRN

If the BRN contacts you or opens an investigation into the patient abandonment allegation, be honest but strategic in your response. Address the situation calmly and professionally, acknowledging any mistakes and highlighting the challenging circumstances you faced.

Focus on any mitigating factors, such as the fact that you left due to bullying, micromanagement, and mental health concerns and that there was still another RN present to manage the unit in your absence.

Mental Health Considerations

Since this situation has taken a toll on your mental health, consider seeking support from a counselor or therapist. They can help you process the situation's emotional impact and provide documentation if your mental health becomes a relevant factor in the case.

If you decide to continue working as a nurse, it may be helpful to explore ways to protect your mental health in the workplace, such as developing boundaries, finding a healthier work environment, or seeking support from a supervisor or union.

Prepare for Possible BRN Actions

Depending on the BRN's investigation, they may issue a warning, require you to complete additional education or training, or take more severe actions. Your lawyer will be instrumental in helping you understand the potential outcomes and how to mitigate any penalties.

Be aware that the BRN will likely want a detailed account of why you left your shift, how it affected patient care, and what steps you took to ensure your responsibilities were covered. Keep all your documentation organized and ready for review.

Future Steps for Your Career

If you are facing disciplinary action, think about how you want to handle your nursing career moving forward. If you plan to continue practicing as a nurse, you'll need to work on rebuilding your professional reputation.

Look into taking continuing education or training courses that demonstrate your commitment to safe patient care and professional growth, especially if your behavior or actions are questioned.

Very best wishes,

Nurse Beth

[ER_CHAOS]

Thank you so much