Accused of abandonement

nursemike, ASN, RN · Dec 16, 2007

I have to agree with Daytonite that, while this doesn't sound like true abandonment, it would be a grave error to make light of it. Once you take report and accept the assigment, you're the nurse of record. I wouldn't have written you up, either, but you definitely needed to learn the right way to handle the situation. (I don't usually announce potty breaks, but I have a portable phone with me so I can still be reached. If I was smarter, I'd hand it off to a coworker and toilet without interruption.)

On the other hand, being written up isn't the end of the world, usually. I imagine this was an incident report, since it was by a peer. At least where I work, an incident report is not a disciplinary action--it merely notes an irregular occurence, and often no one individual is at fault. If you get "written up" by management, it's a disciplinary letter, but usually the first level of discipline is counselling, and your job isn't at stake, as long as you listen. Mistakes are inevitable, and expected, and we learn and move on. Getting defensive is not the way to go. Accepting responsibility lets management know that you won't be likely to make the same mistake, again. It's important to convey, to your manager and your peers, that you view your duties as solemn ones. It's not just a job, it's a commitment.

I'm a bit concerned about the business of not being clocked in. If you are taking report, you should be on the clock. I usually come in early, on my own time, to review my Kardexes over a cup of coffee and get an idea what's ahead of me, but I won't take report before I clock in. It's not just that I deserve to be paid--which I do--but it keeps things a lot more clear if a legal issue ever arises. If I'm doing hospital business, I'm on the clock.

LydiaNN · Dec 16, 2007

I have to agree with Daytonite that, while this doesn't sound like true abandonment, it would be a grave error to make light of it. Once you take report and accept the assigment, you're the nurse of record. I wouldn't have written you up, either, but you definitely needed to learn the right way to handle the situation. (I don't usually announce potty breaks, but I have a portable phone with me so I can still be reached. If I was smarter, I'd hand it off to a coworker and toilet without interruption.)
On the other hand, being written up isn't the end of the world, usually. I imagine this was an incident report, since it was by a peer. At least where I work, an incident report is not a disciplinary action--it merely notes an irregular occurence, and often no one individual is at fault. If you get "written up" by management, it's a disciplinary letter, but usually the first level of discipline is counselling, and your job isn't at stake, as long as you listen. Mistakes are inevitable, and expected, and we learn and move on. Getting defensive is not the way to go. Accepting responsibility lets management know that you won't be likely to make the same mistake, again. It's important to convey, to your manager and your peers, that you view your duties as solemn ones. It's not just a job, it's a commitment.
I'm a bit concerned about the business of not being clocked in. If you are taking report, you should be on the clock. I usually come in early, on my own time, to review my Kardexes over a cup of coffee and get an idea what's ahead of me, but I won't take report before I clock in. It's not just that I deserve to be paid--which I do--but it keeps things a lot more clear if a legal issue ever arises. If I'm doing hospital business, I'm on the clock.

It isn't my understanding that the OP is objecting to being written up though. It is those particular words "patient abandonment". When the definition of a term is spelled out by the BON, I don't think facilities should use that term to describe any offense other than those activities that fit the BON's specific criteria.

How would a write up warning this poster to follow the facility protocol re: informing colleagues and supervisors about her whereabouts at all times have been less effective than a write up for abandonment, when that charge clearly doesn't apply?

I do agree with your point about being clocked in.

tencat · Dec 16, 2007

The OP did wrong.....she had the duty to report where she was to everyone that needed to know (preceptor, other staff), and she did not. Patient abandonment? Ummm....not really. A write up for patient abandonment in this case is kind of analogous to using a sledge hammer to put a tack in the wall....overkill, unnecessary, messy, damaging.

I really believe that this kind of managment style is part of the reason why so many nurses are demoralized and ultimately quit nursing. No one died. Patients were ok. Yes, some sort of reprimand is called for, but not such a punitive, demoralizing one. Patient abandonment is a very serious charge that hits a nurse right in his/her core. If it really occurred, then it has to be documented as such, regardless of how the nurse in question will feel. But in this case I really don't see how it applies as a true charge, and now there is a nurse who cannot trust her workplace to be fair to her or support her through her mistakes. As another poster said, this is a prime example of 'eating our young'. :trout: There are better ways to make a point to a new employee.

Mulan · Dec 16, 2007

Some in management throw that word around a lot, they use it as a scare tactic.

They don't think that we are smart enough to know what is and what isn't patient abandonment as defined by the BON (not by them).

marie-francoise · Dec 16, 2007

If this is the type of treatment I can expect when I graduate, I guess I'll just be contributing to the nursing shortage by saying "B'bye", rather than working in a disrespectful environment with the toxic biddies that seem to make up the ranks of managers.

A simple, "You're new, so please know you can't do that. Now you know." Believe me, we all learn from our mistakes. We don't need people ganging up on us - especially vets on newbies - to drive the point.

Please. We're all adults. Let's respect each other. "Eating their young" - I believe it. That phrase has become a cliche simply for the fact that it is...... TRUE! That's how cliches come into being.

And, yes, I can see how that phrase "abandonment" would get abused to strike fear into nurses' hearts. Geez Louise. No wonder there is a nursing shortage.

Mulan · Dec 16, 2007

How long were you in her office? Was it longer than a bathroom break?

Daytonite, BSN, RN · Dec 16, 2007

We don't know the whole story here. I've been in management and supervision. I think there may be things the OP hasn't revealed. Also, a write up for abondonment is a big attention getter and I suspect from my background in management that this was done not only because of the primary infraction and an opportunity because a rule was broken, but possibly because of some other issues that may be going on as well. The fact that the OP pointed out in the initial post that her preceptor was responsible indicates a serious lack of responsibility in regard to her job duties. We learn from Day 1 of nursing school that we are all responsible for our actions. That, I felt, was a big error in thinking that may be part of the real problem that this manager has to deal with. I'm wondering if there were other incidents where the OP blamed her preceptor or others for things that happened. Just my thoughts on this. If I had a new employee that had that kind of thinking (blaming everyone else for their errors) and it was getting to be a regular habit, I'd be looking for any ways I could to get this person off my unit as this is trouble waiting to happen down the road. Mind you, I'm not saying this is what is going on, just my thoughts on it as I was reading the original and second post. Most of us know that as new grads, and even as new employees, when you make a mistake, the respectful thing to do is to own up to it, correct yourself and don't do it again. You don't profess to know all the facility rules better than your boss. You don't start talking about who to blame instead of yourself and how to file a grievance. I'm wondering if the OP expressed any of these thoughts to fellow employees which would be one more mistake to add to this mess which the boss wouldn't like at all. Again, just my thinking. These are the surest ways to cause negative unwanted attention to yourself. It's very hard to write someone up for their bad attitude. But, breaking a rule gives the boss legitimacy to throw the book at you when they could just give you an informal slap on the hands and a "tsk tsk" and it could be all because of an employee's general unacceptable attitude.

Daytonite, BSN, RN · Dec 16, 2007

Please. We're all adults. Let's respect each other. "Eating their young" - I believe it. That phrase has become a cliche simply for the fact that it is...... TRUE! That's how cliches come into being.

"Eating their young" has to do with people, not necessarily managers vs staff, who act in a bullying and nasty way to others in an intimidating way in order to deliberately belittle them. I've seen plenty of staff nurses go after other staff nurses and "eat them". This post is an issue about a manager correcting the wrongdoing of a staff nurse. "Eating their young" doesn't apply here.

marie-francoise · Dec 16, 2007

"Eating their young" has to do with people, not necessarily managers vs staff, who act in a bullying and nasty way to others in an intimidating way in order to deliberately belittle them. I've seen plenty of staff nurses go after other staff nurses and "eat them". This post is an issue about a manager correcting the wrongdoing of a staff nurse. "Eating their young" doesn't apply here.

Actually, I was talking about the tone of some of the responding posts here.

Simplepleasures · Dec 16, 2007

we don't know the whole story here. i've been in management and supervision. i think there may be things the op hasn't revealed. also, a write up for abondonment is a big attention getter and i suspect from my background in management that this was done not only because of the primary infraction and an opportunity because a rule was broken, but possibly because of some other issues that may be going on as well. why not correct her for the things she has done wrong, so she can improve, why lump them together and charge her with a very serious infraction like abandonment?this is a tactic i have seen dons do and it is not admirable. mo.the fact that the op pointed out in the initial post that her preceptor was responsible indicates a serious lack of responsibility in regard to her job duties. we learn from day 1 of nursing school that we are all responsible for our actions. that, i felt, was a big error in thinking that may be part of the real problem that this manager has to deal with. i'm wondering if there were other incidents where the op blamed her preceptor or others for things that happened. maybe the preceptor was not doing something right and the new nurse had to complain about her ethically and legally.you are right we dont know the entire story, but i wont jump to conclusions and blame the new nurse for abandonment-very serious charge.just my thoughts on this. if i had a new employee that had that kind of thinking (blaming everyone else for their errors) and it was getting to be a regular habit, i'd be looking for any ways i could to get this person off my unit as this is trouble waiting to happen down the road.as another poster stated , no wonder there is a nursing shortage,management can be guilty of eating their young , they seem to have an appetite for this kind of punitive overreaction. mind you, i'm not saying this is what is going on, just my thoughts on it as i was reading the original and second post. most of us know that as new grads, and even as new employees, when you make a mistake, the respectful thing to do is to own up to it, correct yourself and don't do it again.she did own up to the mistake of not telling her precepter where she was going.she is correct not to be bullied into agreeing she abandoned her patients. you don't profess to know all the facility rules better than your boss. you don't start talking about who to blame instead of yourself and how to file a grievance. i'm wondering if the op expressed any of these thoughts to fellow employees which would be one more mistake to add to this mess which the boss wouldn't like at all. again, just my thinking. these are the surest ways to cause negative unwanted attention to yourself. it's very hard to write someone up for their bad attitude. but, breaking a rule gives the boss legitimacy to throw the book at you when they could just give you an informal slap on the hands and a "tsk tsk" and it could be all because of an employee's general unacceptable attitude.again, if these are the tactics that are considered acceptable by management, to "throw the book" at someone for stepping on some toes, well, again, no wonder there is a nursing shortage. we need a culture change in the healthcare field. this is a prime reason some facilities find themselves in a lawsuit by the former employee.

to the op, keep your chin up, but welcome to the world of nursing.

Simplepleasures · Dec 16, 2007

"Eating their young" has to do with people, not necessarily managers vs staff, who act in a bullying and nasty way to others in an intimidating way in order to deliberately belittle them. I've seen plenty of staff nurses go after other staff nurses and "eat them". This post is an issue about a manager correcting the wrongdoing of a staff nurse. "Eating their young" doesn't apply here.

I respectfully disagree with your premise, management eats nurses and spits them out, why do you think there is such unrest and unhappiness in the workplace in hosptals and nursing homes? The punitive overreactive style of managing should by now be a thing of the past.All the more reason to have unions in place.

UM Review RN, ASN, RN · Dec 16, 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?

I guess I don't get it because you say you were in the manager's office, yet the manager wrote you up for patient abandonment?

If it was your preceptor who wrote you up, you'd go to the manager. Where I work, the manager sees all the writeups anyway, so that'd be the logical place to start.

Was it warranted? To me it sounds pretty extreme. I know that if I was written up for something like that when I was new and already having problems with my preceptor, my first thought would be to get off that unit.

I guess it depends on how long you were gone and what was going on with the patient you had taken assignment on.

We're usually pretty flexible with the new grads. If I'm precepting and for one reason or another, the grad is having a tough day and simply can't handle it, that's my cue to step in. IMO, any preceptor needs to be able to step in and immediately take over that patient when the going gets rough. I think this is what you were presuming when you went off to your manager's office, but if you failed to tell the preceptor you were going and give an update on that patient, you could see how there could be a problem if the patient suddenly took a bad turn. Whenever someone goes bad, the first thing everyone wants to know is where is their nurse, what's happening, and then a history of the patient. However, if you're not available, no one knows who's done what and why the patient is suddenly having problems.

So yes, it can be considered abandonment if you simply up and leave your patients without telling anyone about them. I was worried about this myself one night when my rebellious ol' body had the nerve to go into Vtach on me while I was charting on my patients. I gave Report as they were whisking me to the ER.

Giving Report is one of those nursie things that is such a basic, core concept that it becomes part of our cellular structure after a few years.

Next time you might make sure you are on the clock, then ask your preceptor to take report if you need to speak with the manager first. If your hospital is like mine and you cannot transfer for six months without manager approval, keep your head down and fly under the radar for the next few months. Who knows, by then everything might work itself out.

And please let us know how it goes. There are a lot of us who care and want you to succeed.