Did I abandon my patient?

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I work the night shift and we have a nurse on days who does not care to take report. Let's call him nurse

Anyway last night I had five patients and this morning I reported off on 4 of them. Then came nurse's patient, a person with an EF of 10% going for a new pacer/icd in a few days while waiting for their heart transplant workup. The only reason they are not at home is because our transplant team is the only one who will talk to them and they live 200 miles away.

Nurse was not in the report room which is typical for him. If you have something to tell nurse you have to chase his butt down and tell him. You have to find out what rooms he has and have to wait for him to finish with the patient and then he'll come out and say, "I don't have any questions" and walk away and if it's really important you have to run after him and tell it to his back.

So this morning I said to myself, "Self, nurse had this patient yesterday and knows him (i've abandoned gender non-specific language. HIPAA-schmipaa. I'm too tired) You've had this patient for 5 days and in that time you have gotten him tylenol for a headache once and gotten him a container of cranberry juice once and given him his spiriva 5x. Your carpool is going to leave you and you will have to ride the bus home and you know some crack-head will want to share your seat." So I left.

But (this just registered in my brain) on the way out I saw a pile of kardexes and bridge worksheets on the table with a "nurse" sticky note on them. Maybe nurse was not there yet. Or maybe he knew all his patients and left his notes there. Anyway, did I break the law? The kardexes include the shift assessment as well as a narrative shift summary so if he shows up he'll know what's going on. The ANM in that shift is fabulous to new grads and mellow so I doubt I will get in trouble, but you know how things nag at your mind. I know in the future I'll be tracking his back down and telling it my reports so I don't have to be a worry wart. I guess if he really wasn't there the charge would have to hear report.

Sorry to ramble so long (and sorry for the excessive use of parenthesis (it's an affectation)).

Laura (parenthesis abuser/patient abandoner)

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Yes you did. It is every RNs responsibility to make sure their patients care has been transfered to a qualified care provider. Sounds like nurse has issues and you need to make management aware of them, his behavior is unprofessional and dangerous. If he really wasn't there you should have made sure some nurse (charge or whatever)knew this and could care for the patient before you left.

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I've always been told that in such a situation, no relief in sight, to give report to, or leave a written report with, the oncoming charge nurse or nurse supervisor. They can't expect you to stay all day or chase this person down. But you have to give report to someone. It is better to leave a written report so anyone filling in at the last minute can have something to go by.

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quick replies! See, that's what I thought. There is a written report on the kardex, but if no one HAS the kardex it's not going to do any good. Poop. OK, I guess I'll call. It was inadvertent, but of course still not ok on my part. At least I know I'll never let this happen again. I make new mistakes, but rarely make the same one twice.

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I called. The ANM laughed at me and told me to go back to sleep. I'm such a dork. She said, "Nurse was late. Did you have anything to add?" and I said no so she said, "You're fine! Go back to sleep!" I could hear her eyes rolling from here. But I'll be reporting to anyone who will listen to me from now on!!

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I called. The ANM laughed at me and told me to go back to sleep. I'm such a dork. She said, "Nurse was late. Did you have anything to add?" and I said no so she said, "You're fine! Go back to sleep!" I could hear her eyes rolling from here. But I'll be reporting to anyone who will listen to me from now on!!

I'm not looking to dump on you -- we all make mistakes and, hopefully, learn from them. But, yes, what you did would generally be considered abandonment. You were lucky -- if anything had gone wrong with the client, you would have gotten an entirely different response from your ANM (and everyone else up to and including the CNO) -- they would be in the process of hanging you out to dry ... I'm glad you were able to learn the lesson without any serious consequences. :)

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Specializes in Utilization Management.

While you had the manager on the phone, you might've just mentioned what a chore it is to get this guy to take report. ;)

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I'm not looking to dump on you -- we all make mistakes and, hopefully, learn from them. But, yes, what you did would generally be considered abandonment. You were lucky -- if anything had gone wrong with the client, you would have gotten an entirely different response from your ANM (and everyone else up to and including the CNO) -- they would be in the process of hanging you out to dry ... I'm glad you were able to learn the lesson without any serious consequences. :)

I don't feel dumped on by your comment, I actually appreciate it. That's the problem with the mellow ANM, no constructive criticism. And she also says, "Oh, that's just nurse's way. If you have a good shift summary he doesn't look for you". But shift summaries print 2 hours before end of shift and a LOT happens in that 2 hours.

You are right. I was lucky! I don't want to be that kind of nurse! People have made fun of me before as I follow him down the hall trying to force him to listen to my updates, but until today I always ignored them. I wouldn't have done it with any other nurse. If it hadn't been a stable patient I wouldn't have let it go like that, and on our floor a stable patient doesn't mean crap. I can't even count how often I've come back the next night and said, "What happened to Mr Smith?" and find out he went into vtach or something and is now intubated in cicu or worse. Now hopefully this thread gets burried before everyone sees how dumb I was! I know I'll never be perfect but I ought to be able to avoid blatantly stupid mistakes!

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
And she also says, "Oh, that's just nurse's way. If you have a good shift summary he doesn't look for you".

*** Your facility must not be JACO certified. If ir was I think your ANM would not want you to be honest when the surveyor asks you if there is the opportunity for face to face questions at hand off time. They thinks its important.

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Specializes in oncology, trauma, home health.

I think nurse works at my facility too!

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Specializes in LTC, Nursing Management, WCC.

Well I wanted to reply but than I noticed that Silverdragon102 was editing and sending PMs to members. :omy:

Hee hee.

~Psych

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Specializes in Telemetry, ICU, Psych.

What I would do is find "nurse" or the charge nurse, give them the low down, and chart report given to ______,RN. At my hospital we also sign the orders sheet with a 12 hour chart check at the end of our shift. This way, if anything goes down, you are clear.

I HATE giving report to nurses that cut you off saying, "I already know" or "I'll read about it later." They don't realize that as I give you report, I'm checking through the orders, MARS, labs, etc. to make sure that I caught everything for my shift. Giving report is helpful the both the oncoming nurse and the leaving nurse.

CrazyPremed

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