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Abandonment

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I work in a busy ICU. When I arrived to my shift at 3pm I felt fine. I admitted a patient at 4pm who was very critical (on multiple drips,etc). I charted his admission assessment but after that was unable to chart until about 8:45pm. Around 9pm I suddenly felt very ill and was getting sick in the bathroom. I was continually sick until 9:30. I then told my charge nurse that I could no longer work and had to leave. The nurse who was taking over asked me what drips the patient was on but I was physically unable to give her a full report. I clocked out at 10pm. Now I am being suspended indefinitely and my license is being threatened for abandonment by my boss. Anyone have experience with this? I had nothing charted because when I sat down to finally chart, I was suddenly ill and was also unable to give report.

Why didn't you notify the charge nurse at 9: 00 that you felt ill instead of waiting until 9:30?

I was in the bathroom getting sick for 30 mins. I had another nurse watch my patient during that time. @sevensonnets

Contact your malpractice insurance company as soon as they open in the morning. You need a lawyer who's experienced in this kind of thing and I'm assuming they can give you advice.

Does getting sick refer to active v/d, etc.? How did you make it home?

This seems like an awfully harsh reaction on their part. I'm sorry for asking but is there more to the story? Are they suggesting this was contrived or what? I've never seen or known of a coworker being treated this way over being actively physically ill at work, even if they have given reports that are very brief or not up to usual expectations.

Why weren’t you able to give report? You were able to drive home, correct? I get you were sick, it happens, but they got you a replacement. Give some type of report.

JadedCPN, BSN, RN

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 15 years experience.

1 hour ago, LovingLife123 said:

Why weren’t you able to give report? You were able to drive home, correct? I get you were sick, it happens, but they got you a replacement. Give some type of report.

I agree with this. Assuming you were able to drive home, you should have been able to struggle your way through a brief report for the sake of patient safety. Granted, I think their reaction may be a bit too strong.

NICU Guy, BSN, RN

Specializes in NICU. Has 6 years experience.

11 hours ago, Eklusty1 said:

The nurse who was taking over asked me what drips the patient was on but I was physically unable to give her a full report.

Did you give her any type of report? A compassionate coworker would say "give me what I need to know and I can figure out the rest". I never leave work without some type of verbal acknowledgement from my relief: They need to say either "Have a good night","See you in the morning", or "Thanks, I got it". If they walk off, I ask them before I leave and say "Are we good?". That way I have proof that they verbally accept the patients.

If you couldn't even go over the drips, then it seems like you didn't give any type of actual report.

kp2016

Has 20 years experience.

On 3/18/2020 at 10:23 PM, Eklusty1 said:

I admitted a patient at 4pm who was very critical (on multiple drips,etc). I charted his admission assessment but after that was unable to chart until about 8:45pm. Around 9pm I suddenly felt very ill and was getting sick in the bathroom. I was continually sick until 9:30.

I had nothing charted because when I sat down to finally chart, I was suddenly ill and was also unable to give report.

I suspect there are actually 3 issues here, patient was

"very critical",

"I had nothing charted"

"unable to give report"

I agree it's harsh to throw you under the bus for getting sick at work. I'm guessing if the patient's condition declined or a complaint was made by the family management might think they would have a hard time defending the care he recieve and that notion that "their facility" didn't fail in its duty of care therefore contributing to a poor outcome.

Is there perhaps a bigger problem like maybe a poor outcome or a family complaint?

Closed Account 12345

Has 14 years experience.

Patient care is certainly a higher priority than charting, but I find the total absence of charting for an almost 5 hour gap on a critically ill patient with multiple drips concerning. That's not just a little behind.

Hopefully when you charted at 8:45 you were able to catch up documentation for that entire stretch.

Otherwise, from a legal standpoint, the care did not occur... And to anyone who reviews the patient's chart, they would, in fact, appear abandoned. It goes back to the Documentation 101 principle of "If it wasn't charted, it wasn't done."

Personally, if I were caring for an unstable, critically ill patient, I would call my charge nurse from the toilet as soon as I realized I was too sick to leave the bathroom. Who had eyes on this critically ill patient during that 30 minute span?

That said, I'm sorry you got so sick, and I hope there is a good outcome for you in this situation.

Katie82, RN

Specializes in Med Surg, Tele, PH, CM. Has 39 years experience.

Sorry to say, this may meet the legal criteria for abandonment. The argument would be that if you were capable of walking out of the hospital and driving home, you were capable of a two minute report to hit the high spots.

Thanks for the responses everyone. It all worked out for the best.

Jory, MSN, APRN, CNM

Has 10 years experience.

If you drove yourself home, let's be honest...you were well enough to give report.

If you didn't go straight to the ER, you weren't that sick.

It meets the criteria and yes, they should pursue it. It doesn't really sound like you had permission to leave either.

I had to go to the ER once when I still worked the floor and my manager came down and took report from me on my patients.

I agree with you Jory. If someone's that sick that they leave the floor midshift without giving a report, they had better be headed to the ED. I've never heard of a digestive upset that would render someone speechless.

If you are vomiting or having terrible pain or diarrhea, you aren't going to do too much talking.

OP, glad it worked out well. How did that happen?

I agree it would have been smart to go to the ER.

Edited by Kooky Korky

On 3/19/2020 at 11:39 AM, kp2016 said:

I suspect there are actually 3 issues here, patient was

"very critical",

"I had nothing charted"

"unable to give report"

I agree it's harsh to throw you under the bus for getting sick at work. I'm guessing if the patient's condition declined or a complaint was made by the family management might think they would have a hard time defending the care he recieve and that notion that "their facility" didn't fail in its duty of care therefore contributing to a poor outcome.

Is there perhaps a bigger problem like maybe a poor outcome or a family complaint?

Did you see that she charted the admission assessment? Why focus only on what she couldn't do instead of acknowledging that she did her best?

JadedCPN, BSN, RN

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 15 years experience.

7 minutes ago, Kooky Korky said:

Did you see that she charted the admission assessment? Why focus only on what she couldn't do instead of acknowledging that she did her best?

Most places I’ve worked at give you a 24 hour timeframe to complete an admission assessment. I would much rather actually get report on a critical patient drips running rather than have their admission assessment complete.

OK everyone. I should clarify. I charted the admission assessment and a few other things. But was not completely caught up with charting. I also told the oncoming nurse what drips the pt was on and left a written report that I wrote while on the toilet (TMI, but at this point it needs to be said). After that, I left. I did not give a full verbal report. The only verbal report I gave was the drips, the rest was written. I quit that job after they threatened my license and got a new job the next day. It all worked out. I realize I was mostly in the wrong. I also did not drive home right away. I had to make multiple bathroom stops on the way out of the building and sat in my car with a bag to throw up in for about 20 mins before I left the parking lot. I made it home before I spent the night on my bathroom floor. I was sick with N/V/D and a fever for 2 days. I returned to work a day after I felt better and that's when they threatened my license. I quit the next day. I applied for a new job the same day I quit and had an interview the following day. Two after after the interview, they called and made me an offer. I have been a nurse for 4 years, have my CCRN,FCCS,ACLS,PALS,CVVHD certifications. By no means am I a lazy nurse and I have never had disciplinary action before. This was a one time occurrence that I should have thought out differently before I clocked out. Thank you all for the input.