When refusing to work is considered abandonment?

Nurses General Nursing

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If a nurse is given an unsafe assignment, say with patient rations she/he deem to be unsafe what is the consequence to simply refusing to take the shift?

Agreeing to an unsafe situation and making a mistake will likely be blamed on the nurse and not the employer. You signed for therefore you are responsible. But refusing to stay can be considered abandonment? That seems to be the only option left for these kinds of situations. Calling the state will do nothing because the facility is "under safe ratios"

If the employer refuses to hire sufficient staff, there is not mechanism for the nurse to protect themselves, because state ratios are not always clear due to different working situations or pt's acuity. So it is really for the nurse to judge what is safe and what is not.

What are your thoughts?

Do you have a way to fill out an incident report or unsafe staffing report? Ive been told you cannot refuse bc it IS abandonment but to just take the assignment but fill out an incident report to protect yourself if anything happens.

In our facility, if you leave before your replacement shows up, it is abandonment

This is also my understanding. Once you take the responsibility, it is yours until you hand off to someone.

There are three separate issues being blurred here.

First, most BONs will not censure you for abandonment unless you have taken report and then leave. But that means if your replacement doesn't show up and you leave, they can censure you for abandonment.

Second, unless you have union protections, in most states your employer can legally fire you for just about anything unless the termination represents discrimination against a protected class. So yes, if you refuse to take report for an unsafe assignment or leave without your replacement having taken the assignment, they can fire you.

The third issue is potential legal repercussions against you if something goes bad while working an unsafe assignment. If you elect to stay, it's very important to send an email to your supervisor that you are staying under protest in order to not abandon your patients but you believe it is an unsafe assignment and briefly give the reason and keep a copy of the email.

This abandonment charge threat is used by many facilities to solve their staffing problems. It's why the Department of Labor in New York and other states have highly specific circumstances under which nurses can be legally mandated to stay and whistle blower protections in place for nurses who report violations.

I guess what I forgot to mention is that this is a SNF facility. 2 nurses per PM shift with a 35 (average) pt load. Some are very sick an demanding and really impossible to have just one RN. The other RN is sick and no one else will stay to work. So you're left along with these 35 patients. What do you do? Do you leave or stay?

I left. I was about to receive report when the offgoing nurse started to make it clear what a horrid shift she had directly related to a sudden increase in pt load. (Our unit was switching from strictly post acute rehab patients to LTC patients. Only we still had all the post acute rehab patients, about 15, AND LTC patients, bringing the sum to 24. 15 patients one week, already struggling, to 25 the next week.)

I had back to back scary dangerous shifts. So I finally had it. Before report I went to the office and stated I was refusing the assignment. I said I would be willing to work another unit. Instead they told me, either stay and do the assignment, or leave and we will report you to BON for pt. abandonment. Even though I explained to them that is NOT pt abandonment, they doubled down and repeated themselves. Then they had the nerve to say I quit. No. I refused an assignment. YOU are the one telling me I can't come back. YOU are firing me. They insisted, that no, I had quit.

Big shock its a year later almost, and I have not once been notified of any BON repercussions. An idiot DON and ADON probably called and was told that was not a reportable offence. A-holes

Edit: oh, and guess what happened at the facility? The other nurses continued complaining about the workload. 2 nurses who were recently hired for that unit quit. Soon after, they continued with the process of changing from post acute rehab to LTC but hired an LPN to be a desk nurse to handle admissions and all sort of paperwork and physician orders freeing up a LOT of time for the floor nurses. I'd *like* to think I played a part in this positive outcome. They really thought I was going to cave and do the shift. Everyone was shocked I didn't. I hope I made it easier for the other nurses to speak up.

I'd deal with the shift but look for a new job. If there are only two of you it is not fair to the other nurse. S/He is going to need your help. 35 to 2 is extremely unsafe. Especially, if they are high acuity.

I work LTC. We have a mix of skilled residents that need a lot of care and long-term intermediate care residents. When you say 35 residents do you mean each or split between two nurses? Were there CNAs too?

Abandonment only occurs if you accepted the assignment in the first place. If you took report or the keys then yes.

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