Accused of abandonement

Simplepleasures · Dec 15, 2007

During my shift, which I had not actually clocked in but had received report because I had done smething hospital ssociated prior to that day that I needed to fill out a form for, I went to go speak to a manager about an issue I was having with my preceptor. Although I did not leace the unit, because this manager's office is on the unit I was told that I had abandoned my patient assignment. This does not make sense to me because although I know I should have informed my preceptor, I was not included on the census as I am on orientation, and I did not actually leave the unit. Ultimately my preceptor is the one responsible so would it make sense for me to receive a write up for pt. abandonment? Who should I take this to?

Who wrote you up? If it was the precepter go to your NM.Sounds like your preceptor has a bug up her patooty about something.If it was the NM who wrote you up, go to the DON.This IS not abandonment and she has no business telling you so.

meandragonbrett · Dec 15, 2007

During my shift, which I had not actually clocked in but had received report because I had done smething hospital ssociated prior to that day that I needed to fill out a form for, I went to go speak to a manager about an issue I was having with my preceptor. Although I did not leace the unit, because this manager's office is on the unit I was told that I had abandoned my patient assignment. This does not make sense to me because although I know I should have informed my preceptor, I was not included on the census as I am on orientation, and I did not actually leave the unit. Ultimately my preceptor is the one responsible so would it make sense for me to receive a write up for pt. abandonment? Who should I take this to?

You being on the clock or not makes absolutely no difference. What matters is if you have accepted report on the patient. I don't see what the problem is as you were still on the unit. If you had left the unit to go to another floor I could maybe see it. Sounds like you need to have a chat with your NM about what abandonment actually entails according to your BON. I would fight it. You did not abandon your patients.

Daytonite, BSN, RN · Dec 15, 2007

I think that writing you up for abandonment is a little harsh, but you did make a mistake and I sincerely hope that the write-up made it's point.

You can't just go off to talk to your manager about some issue you have and not notify your preceptor or anyone else on the unit where you are going to be!!!! What if one of your patient's needed something? I don't care that you are in orientation and you think your preceptor is responsible. The staff needs to know your location on the unit at all times, including potty and lunch breaks. You are in training and supposed to conduct yourself like a staff nurse. You did something very irresponsible. And, I'll bet if you read your employee manual or your RN job description this is also clearly stated somewhere in there.

Virgo_RN, BSN, RN · Dec 15, 2007

I agree, "abandonment" is a bit harsh, but you should have let your preceptor know that you had a meeting with the NM.

bell83 · Dec 16, 2007

Thanks for the support those of you who understand my point. However daytonite, one-the exclamation marks? and two-, and this is just an acknowledgement of my understanding of the situation. I totally accept responsibility that I should have told my preceptor as this would be more acceptable conduct, however my point in my thread is that I do not believe that it was patient abandonement because I did not leave the unit nor the hospital. I am uncomfortable with the idea of being accused of something which is completely inaccurate. I appreciate the feedback all.

LydiaNN · Dec 16, 2007

If there was writing up to do, I'd think it would be for not informing your preceptor (which you acknowledge you should have done). What point is it that an inaccurate write-up is supposed to make, anyway? "Don't do it again, or we'll write you up for whatever we wish?"

I agree with the posters who feel the write up was a bit harsh, anyway. A simple reminder or at most a verbal warning seems to me like it would have sufficed.

chare · Dec 16, 2007

whether you believe that it was abandonment or not is not important. what is important is what your state board of nursing would say. in north carolina where i practice, it is entirely possible that this would be viewed as abandonment. the following statement was obtained from the north carolina state board of nursing website.

abandonment, assignments, short staffing, extended work hours, and patient safety position statement for rn and lpn practice.

abandonment can only occur after the nurse has come on duty for the shift and accepted his/her assignment. if the licensed nurse leaves the area of assignment during his/her tour of duty prior to the completion of the shift and without adequate notification to the immediate supervisor, it is possible that the board would take disciplinary action. disciplinary action by the board may result from: . . . “abandoning or neglecting a client who is in need of nursing care, without making reasonable arrangements for the continuation of care.” [21 ncac 36.0217 © (10)]

if you have any questions regarding whether or not this is in fact abandonment, your state board of nursing would be the best reference. this might be included in your state's nurse practice act. if it’s not, then you might be able to find their definition of abandonment on their website. if you can’t find it there, your risk management office should be able to provide you with a definition.

your facility might also address patient abandonment in their policies and procedures. if they feel that you are guilty of abandonment (regardless of what your state says), while it might not affect your nursing license, it could definitely affect your job.

if you do not have a copy of your state's nurse practice act you need to get a copy immediately and familiarize yourself with its contents. remember, you are ultimately responsible for your practice.

good luck in your future practice.

Simplepleasures · Dec 16, 2007

whether you believe that it was abandonment or not is not important. what is important is what your state board of nursing would say. in north carolina where i practice, it is entirely possible that this would be viewed as abandonment. the following statement was obtained from the north carolina state board of nursing website.
abandonment, assignments, short staffing, extended work hours, and patient safety position statement for rn and lpn practice.
abandonment can only occur after the nurse has come on duty for the shift and accepted his/her assignment. if the licensed nurse leaves the area of assignment during his/her tour of duty prior to the completion of the shift and without adequate notification to the immediate supervisor, it is possible that the board would take disciplinary action. disciplinary action by the board may result from: . . . "abandoning or neglecting a client who is in need of nursing care, without making reasonable arrangements for the continuation of care." [21 ncac 36.0217 © (10)]
if you have any questions regarding whether or not this is in fact abandonment, your state board of nursing would be the best reference. this might be included in your state's nurse practice act. if it's not, then you might be able to find their definition of abandonment on their website. if you can't find it there, your risk management office should be able to provide you with a definition.
your facility might also address patient abandonment in their policies and procedures. if they feel that you are guilty of abandonment (regardless of what your state says), while it might not affect your nursing license, it could definitely affect your job.
if you do not have a copy of your state's nurse practice act you need to get a copy immediately and familiarize yourself with its contents. remember, you are ultimately responsible for your practice.
good luck in your future practice.

oh for heavens sake, i do believe the bon has bigger fish to fry that this new nurse who was still in training with a precepter. dont fret about this, it will be taken care of without any heads rolling i dare say.she may deserve a write up for not telling preceptor, but abandonment?! :rolleyes:

LydiaNN · Dec 16, 2007

Since I don't know what state the OP lives in, I went to the BON sites for New York and California, our two most populous states. I'm no attorney, but reading their language on patient abandonment doesn't sound like the accusation would stand up in court. I added the italics to spotlight the language to which I added my own comments. Those comments are in parentheses.

From the NYS site:

Can you please give examples of patient abandonment?

Examples of patient abandonment may include, but are not limited to:

New York BON says:

An RN or LPN accepts an assignment for patient care and then leaves the facility (OP didn't leave the facility) without transferring patient care to another qualified individual, when this would seriously impair the delivery of professional care; (OP didn't leave the facility or impair the delivery of professional care, since she wasn't on the census)

California BON says:

The nurse must sever the nurse-patient relationship without giving reasonable notice to the appropriate person so that arrangements can be made for continuation of nursing care by others. (The continuation of the nursing care in this situation is the responsibility of the preceptor, legally speaking. Patient abandonment isn't a charge that should be thrown about lightly, given the legal consequences it can carry).

Simplepleasures · Dec 16, 2007

Since I don't know what state the OP lives in, I went to the BON sites for New York and California, our two most populous states. I'm no attorney, but reading their language on patient abandonment doesn't sound like the accusation would stand up in court. I added the italics to spotlight the language to which I added my own comments. Those comments are in parentheses.
From the NYS site:
Can you please give examples of patient abandonment?
Examples of patient abandonment may include, but are not limited to:
New York BON says:
An RN or LPN accepts an assignment for patient care and then leaves the facility (OP didn't leave the facility) without transferring patient care to another qualified individual, when this would seriously impair the delivery of professional care; (OP didn't leave the facility or impair the delivery of professional care, since she wasn't on the census)
California BON says:
The nurse must sever the nurse-patient relationship without giving reasonable notice to the appropriate person so that arrangements can be made for continuation of nursing care by others. (The continuation of the nursing care in this situation is the responsibility of the preceptor, legally speaking. Patient abandonment isn't a charge that should be thrown about lightly, given the legal consequences it can carry).

EXACTLY right.What kind of disturbs me about some of the harsh responses is that it smacks of nurses eating their young.

Daytonite, BSN, RN · Dec 16, 2007

thanks for the support those of you who understand my point. however daytonite, one-the exclamation marks?

question marks to highlight the importance of what i was writing because you are obligated to keep everyone informed as to your whereabouts when you are a staff nurse and on duty at all times. if you can't be found, then, yes, in the broadest sense you are guilty of abandonment from your employer's point of view and if something serious happens to one of your patients while you are off galavanting around and one of your patients is harmed, or worse, ends up dying, you can pretty much kiss your job and your license good bye. can you imagine how you would feel to come back to your patients and find out that one of them has had something serious happen to them and was transferred off to another unit for care and you missed it all? you can't imagine the inquisition you would be facing for that!

i totally accept responsibility that i should have told my preceptor as this would be more acceptable conduct, however my point in my thread is that i do not believe that it was patient abandonement because i did not leave the unit nor the hospital. i am uncomfortable with the idea of being accused of something which is completely inaccurate.

i don't believe you. in your original post, you said, ultimately my preceptor is the one responsible so would it make sense for me to receive a write up for pt. abandonment? who should i take this to? that doesn't sound like someone who is accepting responsibility and moving on, but someone who wants to fight the discipline they were given. a new employee making waves for not following a very important rule is not a good way to start off at a new job. i'm telling you that it was harsh to be written up, but it could have been interpreted as patient abandonment and your manager was accurate in pointing it out to you although, as i said, i wouldn't have written you up, but i would have given you a stern talking to about it. you wouldn't have liked a stern talking to either, i suspect.

your job position is that of a "staff rn" not "orientee" and your preceptor is not responsible for your activities and actions. you are. you are responsible for all your actions. you need to not do anything like this again and move on. the write up will be in your employee file and will never be seen by anyone else except those in the facility who have the right and access to see your file. be thankful it doesn't get reported to the state board of nursing. let this go, learn from it and move on. i think that if you insist on putting this before some kind of grievance review that they will side with your manager because she followed the hospital policy and rules, unlike you, and you will come away more embarrassed and angry than you are now.