Is this abandonment?

Nurses General Nursing

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Hi, I am a new grad who was hired by a home health agency. They gave me 2 patients to go visit. One was for 2x a week and the other 3x a week. The first patient is in the hospital so I couldnt go see her. When I checked the address of the 2nd patient, he was more than 30 miles from my home so I decided that this job was not for me because the patients are all too far from my home and it just isnt worth it. I called in and left a message saying I would rather not work for them because the patients are too far. They called back and left me a message saying to return the paperwork stating the patients info (which I will do first thing tomorrow) and that what I did was abandon my patients. Can I get in trouble for this? :crying2:

Specializes in Psych.
I'm just confused as 30 miles being "too far." Did you think the patients would all live in your neighborhood? I remember back in nursing school spending a day with a home health nurse and she covered a pretty wide area. (And we got lunch at a fantastic little bookstore that I could never find again.)

Just an anecdotal observation. It's always been interesting to me that the perception of, say 30 miles, seems to differ somewhat consistently between metropolitan dwellers and rural dwellers. A distance of 30 miles and a 50 minute commute is seen as commonplace to the former while the same distance and a 25 minute commute is seen as somewhat of a drive.

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Specializes in LTC, Home Health.

The OP made a poor choice and it is not a choice most of us would have made. I don't think this is a "new grad" issue but I think it is a "maturity issue". This was completely immature and it doesn't take someone with lots of nursing experience to know better. The BON most likely will not get involved in this but I do hope that the OP learns to learn more about what will be expected of her before she takes a job because she doesn't want to burn bridges in this economy.

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Having done home health in two states I find it surprising that you would consider 30 miles far. Most home health easily do 100 miles a day. While agency's try to keep you within a certain mile radius there are many times other needs arrive. I have never heard of an angency not giving a full discription of the patient, their medical problems and any family situation and their location. Maybe as a new grad you didn't know to ask the agency how far from you was the patient--as a seasoned nurse you become better at thinking "is there anything else I need to know before making a decision" regardless if it's medical or personal related.I hope you have atleast called to apoligize for your inappropiate behavior. :idea:

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Specializes in A myriad of specialties.
the op asked "is this abandonment?" in the home health setting. he or she did not ask for shaming comments on what some may perceive to be "unprofessional behavior issues."

i so agree with your reply, multicolinarity; the op doesn't deserve the judgemental shaming comments. the op simply wanted to know if it was deemed abandonment and if he/she could get into trouble over it. responders need to just answer the darn question; not beat the issue(or seemingly the op) to death!!! :mad:

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The OP asked "Is this abandonment?" in the home health setting. He or she did not ask for shaming comments on what some may perceive to be "unprofessional behavior issues."

It's unprofessional for ANY job,to not at least finish your shift before you quit. Just my 2 cents.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
I'm just confused as 30 miles being "too far." Did you think the patients would all live in your neighborhood? I remember back in nursing school spending a day with a home health nurse and she covered a pretty wide area. (And we got lunch at a fantastic little bookstore that I could never find again.)

Indeed. My husband does home health, and he has the "rural team." From where the office is, he routinely drives 50 miles to the south, 70 miles to the north, and 60 miles to the east (and once in a great while he'll have a patient who lives in the town 80 miles to the west, but not too often). He loves it. It's his "me" time when he's driving. And the mileage reiumbursement checks are huge!

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
i so agree with your reply, multicolinarity; the op doesn't deserve the judgemental shaming comments. the op simply wanted to know if it was deemed abandonment and if he/she could get into trouble over it. responders need to just answer the darn question; not beat the issue(or seemingly the op) to death!!! :mad:

yes, because all we should contribute here are pats on the back and "there theres". because that is just so helpful.

here is a kitten and a rainbow for you.

the op needs to know that what she did was appallingly unprofessional, so that she doesn't think it okay and do it again when the fancy strikes her.

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Specializes in Critical Care, Patient Safety.
Man, this just shows the entitled attitude of some new grads these days.. all over people are posting that they can't get jobs, and this one quits over the phone because it's "too far". Wouldn't you find out where the patients would be before accepting a job?

Thank you for your sweeping generalizations about new grads.

Most new grads I know will take any position they can get, and are seeking almost exclusively inpatient positions. The issue presented by the OP is an issue of maturity and professionalism, not about being a new grad.

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Specializes in ED, CTSurg, IVTeam, Oncology.
Yes I know it is unprofessional on my part and I feel very bad but I have never even met the patient. Arent you suppose to meet first to see if you are comfortable with each other?

LOL, sorry, but you're not going out on a date; the unfortunate reality of this profession is, one doesn't get to pick and choose one's patients, not unless one does private duty (even then, you can't be that selective if you ever want to see a regular paycheck).

So, what you're asking is, did you abandon you patient? Let's highlight some of the things that your state BON is sure to look at. Namely, did you have some mitigating circumstance that prevented you from performing (eg. you had a heart attack and was taken unconscious to the ED; you were kidnapped, the patient threw you out of their house, et cetera); if so, then you can certainly make the case that such a failure was through no fault or control of your own. But your reason for performance failure was simply because you didn't feel like going, a factor that was entirely within your ability to control.

Here is also a description of what constitutes abandonment from the New York State Education Dept., which governs the RN profession in NY:

Definition of Abandonment

Abandonment results when the nurse-patient relationship is terminated without making reasonable arrangements with an appropriate person so that nursing care by others can be continued. The legal definition of abandonment as found in section 29.2(a) of the Rules of the Board of Regents states that unprofessional conduct shall include:

Abandoning or neglecting a patient or client under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care, or abandoning a professional employment by a group practice, hospital, clinic or other health care facility, without reasonable notice and under circumstances which seriously impair the delivery of professional care to patients or clients.

Abandonment and Unprofessional Conduct

The decision to charge a nurse with abandonment will depend on an examination of all of the circumstances surrounding a particular situation as assessed by State Education Department staff in consultation with a member of the State Board for Nursing. Key questions considered include:

  • Did the nurse accept the patient assignment, which established a nurse-patient relationship?
  • Did the nurse provide reasonable notice when severing the nurse-patient relationship?
  • Could reasonable arrangements have been made for continuation of nursing care by others when proper notification was given?

An investigation by the Department of abandonment charges would consider whether managerial or supervisory personnel made adequate provisions for competent staffing to ensure necessary patient care in routine situations. The Department and the nurse may obtain a copy of the nurse's written notice of patient assignment refusal in the event of such an investigation.

In most cases, the following situations are not examples of unprofessional conduct nor automatic violations of the Regents Rule:

  • Refusing to accept responsibility for a patient assignment(s) when the nurse has given reasonable notice to the proper agent that the nurse lacks competence to carry out the assignment.
  • Refusing the assignment of a double shift or additional hours beyond the posted work schedule when proper notification has been given.

source: NYS Nursing:Practice Alerts LPN Practice Issues:Abandonment

So based on the above criteria, did you abandon you patient? Let's review: you accepted an assignment without protest, and then when scheduled to perform your duty, abruptly severed your nurse patient relationship for no good reason. So, on the face of it, it certainly seems so. At the least, the described behavior, IMHO, would constitute unprofessional conduct.

Good luck.

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Specializes in CTICU.
thank you for your sweeping generalizations about new grads.
perhaps you should re read my post... you seem to have missed the word "some", so i have helpfully highlighted it for you, below. fyi - the word "some" would mean that i was not generalizing at all.

man, this just shows the entitled attitude of some new grads these days.
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LOL, sorry, but you're not going out on a date; the unfortunate reality of this profession is, one doesn't get to pick and choose one's patients, not unless one does private duty (even then, you can't be that selective if you ever want to see a regular paycheck).

So, what you're asking is, did you abandon you patient? Let's highlight some of the things that your state BON is sure to look at. Namely, did you have some mitigating circumstance that prevented you from performing (eg. you had a heart attack and was taken unconscious to the ED; you were kidnapped, the patient threw you out of their house, et cetera); if so, then you can certainly make the case that such a failure was through no fault or control of your own. But your reason for performance failure was simply because you didn't feel like going, a factor that was entirely within your ability to control.

Here is also a description of what constitutes abandonment from the New York State Education Dept., which governs the RN profession in NY:

So based on the above criteria, did you abandon you patient? Let's review: you accepted an assignment without protest, and then when scheduled to perform your duty, abruptly severed your nurse patient relationship for no good reason. So, on the face of it, it certainly seems so. At the least, the described behavior, IMHO, would constitute unprofessional conduct.

Good luck.

Not to get off topic, but if you refuse to do overtime that is unprofessional conduct? Is that what they're saying? I'm a student so I really don't know. Please enlighten me :)

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Specializes in ED, CTSurg, IVTeam, Oncology.
Not to get off topic, but if you refuse to do overtime that is unprofessional conduct? Is that what they're saying? I'm a student so I really don't know. Please enlighten me :)

At that link that I had provided earlier:

Responsibility of the Health Care Facility

Health care facilities are responsible for providing staff for the patients they accept, respecting the legal and ethical obligation of nurses to protect the safety of patients. Managerial or supervisory personnel should make adequate provisions for competent staffing to ensure necessary patient care in routine situations.

Source: NYS Nursing:Practice Alerts LPN Practice Issues:Abandonment

Refusal to do overtime is not unprofessional conduct. Hospitals are required to make a reasonable effort to provide enough staff for the patients that they accept for care. Mandating that employees fill in (for regular shift positions) with overtime is generally looked upon as a failure to provide adequate staffing. There are extreme or rare cases like declared disasters or emergencies that are government sanctioned situations in which the state mandates professional participation as a condition of one's license. But those are few and far between.
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