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Discussion

Abandonment??

An LPN on 2nd shift is out on leave atm. My LTC facility refuses to use agency to cover her shifts if they can't get an employee to do so. Therefore, on at least two occasions now, there has only been one med nurse and the charge nurse for 55 residents. I don't want to be put into the same situation next week when I work 2nd shift there. Would it be considered abandonment if I refuse to work alone? Your thoughts? Thanx!

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  • Expert

Some state BONs mandate that if the nurse is already in the building when he/she refuses the assignment, it is considered abandonment, even if you haven't even clocked in yet.

Your profile indicates you're located in Pennsylvania. I am not sure if PA is one of the states that views abandonment in this manner, so I would call your state BON to become assured. Of course, you can always bypass any accusations of abandonment by calling into work to resign (quit over the phone).

to me abandonment is when you clock in take over the care for your residents then leave with out proper coverage (another licensed nurse). the ones that really suffer here are the patients , they cannot get the care they need with ratio's like that. i would be for finding another job...what if the med nurse called in... are you stuck with 55 residents and the meds . treatments , meals, charting and all the other good stuff that shows up in ltc... i say run!!!

I do believe that once you are in the building, and especially, if you are present on the unit that is going to be short, that, leaving the building is grounds for abandonment. I would fill out a protest of assignment, citing why it is considered to be unsafe, though.

And, sure, I would attempt to find another position. Only thing though...it seems that most LTC facilities run like this.

  • Expert

I agree with the others on this one. You can avoid charges of abandonment by calling in, but that will turn into a firing or quitting. When you go to another LTC facility, you are likely to find the same conditions. A fully staffed and well run LTC facility will not be in need of new personnel so you can bet that you just might find a worse situation. I can tell you some good stories along those lines. You have to decide whether working under these circumstances is better than being unemployed or taking your chances elsewhere. If you do work short handed, you just have to do what we always did. Prioritize. The meds have to get done. If you have time, then do the worst treatments. Save the others for night shift. Get the CNAs to put the residents to bed early so you don't have to be chasing them all over to pass meds. Minimize and keep your cool. Good luck.

I've always thought that abandonment is after you take report from the next shift and accept your assignment and then leave without notice to your employer. Your state might define things differently, but this is what Washington state defines abandonment as:

"A licensed nurse-patient relationship begins when the nurse accepts the assignment for patient care. Patient abandonment occurs when the nurse leaves the nursing assignment without transferring patient care and giving specific patient information to an appropriate care giver."

https://fortress.wa.gov/doh/hpqa1/hps6/Nursing/documents/A1302.pdf

Basically it is the EMPLOYER's responsibility to find coverage for the patients, not your responsibility. I would be outraged. Are they paying you both nurse's salaries that night?!?!

  • Author

Thanks for all of your replies! I will definitely check with BON on this. The facility I work at has 3 separate buildings, but all the same company. It's this one particular building that really stinks. My "home" building is under renovations, so I've been shuffled a bit here and there to the other buildings, unfortunately.

  • Author

Well, I posed a "what if?" type of scenario to the PA BON:

What if I were to report to work to find that I am the only LPN to pass meds to 55-60 residents (Long Term Care). I feel that not only is this is an unsafe condition, but the residents will suffer as well, in that they won't get the same amount of time or care as they would if the floor were fully staffed with 2 LPNs. What if I refuse to work that night? Is it considered abandonment if I've assessed the situation prior to clocking in?

And this is the response I got:

I can not interpret the regulations in regards to the situation that you describe. If you feel that patient safety is at risk, you can call the Department of Health, Division of Nursing Care Facilities at 717-787-1816 and the Professional Compliance Office at 1-800-822-2113 to express your concerns about patient safety

Thanks again everyone for your input :)

But, then, the facility may say "What if there is NO nurse at all?". Not my arguement...I am with you. But, they may say this.

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