I Left Work Sick- Can I be Charged With Patient Abandonment?

The short answer to whether you can be charged with patient abandonment is .... probably not. But it depends. Read on to learn more... Nurses Nurse Beth Article


Dear Can I be Charged with Patient Abandonment?

I am so sorry this happened to you. Like you asked, it boils down to if you can be charged with abandonment by your state Board of Nursing (BON). Threatening (sick) nurses with their license and/or patient abandonment is a sign of a desperate nursing leader....lacking leadership skills.

The short answer to whether you can be charged with patient abandonment is .... probably not. But it depends.

First of all, it depends on whether or not your employer reports you to your BON. Unless they report you, there is no way the BON will have reason to investigate.

It would seem vindictive of your previous employer to report you, and it would not serve them any benefit, but it's possible. If you are reported, the BON could choose to conduct an investigation. Depending on the findings, you could be subject to the discipline of your license by your state BON. Here is what they will consider:

The BON will look at several things while conducting an investigation to determine if patient abandonment occurred. All three elements have to be met before you can be found negligent.

  • Did you accept the assignment, and was a nurse-patient relationship established?
  • Did you provide reasonable notice when severing the nurse-patient relationship?
  • Could the employer have reasonably made arrangements for continuation of nursing care by others following notification by yourself that you needed to leave?

Accepting the Assignment

Before it can be considered abandonment, a nurse-patient relationship must have been established. A nurse-patient relationship begins when responsibility for the nursing care of a patient is accepted by the nurse. The point at which you received report on your team of patients is when you accepted the patient assignment and the nurse-patient relationship began.

In your case, you accepted the patient assignment, thereby initiating a nurse-patient relationship.

Providing Reasonable Notice

You notified your employer that you were ill. Not once, but several times over several hours.

"I had multiple concerns with continuing my shift and felt I was providing unsafe care to my patients."

Working while you are sick is not safe. You are at risk for processing more slowly, and what I call "having the dumb". "Having the dumb" is what I experience when I'm ill. The way I tell I'm first getting sick is that I feel mentally slow, and I have difficulty concentrating. This before I even have aches and pains. I am absolutely not at my sharpest when I am sick or getting sick.

Nurses need to be alert and vigilant by nature of their job. Imagine an airline pilot working for American Airlines and reporting fever, aches, and shivering before take-off. It would never be allowed due to public safety.

Likewise, nurses should not be confounded by conflicting messages when sick: " Do not come to work sick and expose your patients and others" and "You are subject to discipline if you call in sick." Many nurses, when asked, would admit that they have gone to work sick or tried to stick it out because there was no one to cover. But how many coworkers and patients contracted their infection?

Facilities should support an ethical work environment.

As to "providing reasonable notice": you did.

Severing the Nurse-patient Relationship

In your case, the nurse-patient relationship was severed, and you left without a replacement for your patients.

Bear in mind that once an assignment is accepted, the nurse is responsible for its completion until responsibility can be transferred to another qualified person. You are not to leave until you have handed off care to another nurse.

Severing the nurse-patient relationship without giving reasonable notice to the appropriate person (e.g., supervisor, another nurse) so that arrangements can be made for continuation of nursing care by others is reportable. However, you made every effort for your employer to make other arrangements.

"Can I be charged with abandonment?"

Patient abandonment is defined as "when a nurse caring for a patient needing professional care ceases to provide care before transferring the patient to another nurse." In your case, there was no one to report off to, despite multiple attempts on your part.

In hindsight- one thing you could have done was write out a brief report and hand it to your DON, including a list of what still needed to be done for your patients, and their current status. If this ever occurs to you again, be sure and do this.

Reasonable Arrangements by Employer

You ask, "What responsibility does the facility have to the sick employee?"

The fact that you gave notice that you were sick and unable to provide safe care shifts the responsibility to your employer. They should have made arrangements to provide a replacement and cover the remainder of your shift if you were not well. It is not your responsibility to staff the facility, and employers have to plan for planned and unplanned time off in order to provide safe patient care services.

According to the Joint Commission, employers, not individual nurses, have the responsibility to ensure the continuous and timely availability of nursing services to patients. Employers must provide competent staff to ensure necessary patient care in routine situations.

Patient Abandonment

No nurse ever wants to abandon a patient or plans to abandon a patient or entire patient assignment.

In your case, the BON would look at the mitigating circumstances, including your employer's refusal to provide a replacement after notification on your part. You say you stayed at work several hours, and notified them several times that you were ill and needed to go home. It seems reasonable that your employer could have found a replacement for you in that time and with that much notice.


  • Accepted the assignment and
  • Provided reasonable notice.

Your employer:

  • Did not make arrangements for your patients to be cared for

Please keep us updated. I sincerely hope you have found employment in a better environment, with an employer who respects and values you.

Well, one night shift a co-worker's FIL died. We did not even make a peep, just divided the patients and let her go home. Peeps these managers need to stay home and not work any more. Do you realize so many people died in the recent flood in Texas because their managers threatened to fire them if they did not come to work.

Specializes in Transitional Nursing.

I feel like if she were to report you she'd risk getting her own licence disciplined.

Just in case, write down your version of the entire days events so you don't forget.

Specializes in Psych, case-management, geriatrics, peds.

It isn't society - it's the nursing profession. Paid slaves - work until you drop, work until you get so sick you put your patients and yourself in jeopardy. God how I hated bedside nursing.

Specializes in Psych, case-management, geriatrics, peds.

Yes, but damned if you do and damned if you don't. If you call in sick, they have a hissy fit. If you come in sick, you risk you r health and everyone else's. You can't win.

Specializes in Psych, case-management, geriatrics, peds.

This is treating nurses as professionals?!? Hope absurd. In no other profession would an employee be expected to work while they were deathly ill - only in nursing. Until nurses stop allowing themselves to be treated like doormats, this abuse will continue.

Specializes in ICU, Postpartum, Onc, PACU.

Same story gets repeated so many times...they holler at us for calling in sick, but if we come to work sick, people get irritated that we're not performing at our best and upset that they may catch something from us. :banghead: I don't know what to tell you, but the advice you got originally seems the soundest: You tried your best to make arrangements and jack nothing was done about it. I would think that would come back on the HOSPITAL for not finding your replacement despite ample notice!

Hope you find something else soon!


Specializes in Operating Room.

I would have just crumpled on the floor- now they have one more patient to take care of, and you are off the hook.

Truly sorry this is happening, hope it works out for you.

You can't help that you became ill?

I once was sick and vomited in the hallway in front of a family

I was running a fever and my charge nurse made me go home.

A compassionate manager understands that employees can be sick also.

kbrn2002 said:
As you made every reasonable attempt to cover the rest of your shift including giving report and the keys to the DON, who is by the way a nurse that should be perfectly capable of taking over in an emergency like this I can't imagine any state would find grounds for calling this abandonment.

Sounds like you are well rid of this place! Just a stupid and totally rhetorical question...why didn't the ADON that promised you a relief or the DON that you eventually resorted to handing the keys to take over? Sheesh! Maybe it would've been more effective if you had just vomited on one or the other [or both] of them. Just kidding there, I think.

I totally agree with you.

I would very seriously consider suing the former employer including all nursing leadership right up to the DON. If you have a good attorney I think you'd win. This is such typical crap from the top and it makes me glad I'm retired. After 35 years I could take no more.

Specializes in Med/Surg/.

"Abandoned Pt." I have read many of the comments and I will say to you do not think the worst......Many of these comments will scare you. Nurse Beth gave you good info of what constitute this act. I read your story 3 times and in my humble opinion you did all you could do to provide for your Patients. I am finding the majority of wrong is in the administration and your DON. You made your case. They promised to find a replacement. If nothing else the unit manager/DON could have worked the floor. That is their job if a nurse is needed and they aren't really trying to find one.(I worked on an Oncology floor where the Charge Nurse insisted on another Nurse and eventually told the Unit Manger to get her A$# in here now. That's the nice/short version. She came and worked and no more said about it). Now that is a charge Nurse! and that responsibility falls on the UM first then the DON. I am in agreement with many of them that they might not even call the BON. Be glad that you are gone from there. The one thing I will stress to you is to sit down and document(detail)your day and when,who you spoke to which time. Then get some of your co-worker to attest to your misery and trying to get a replacement to go home. They can do that without repercussions...document,document,document. This worked for me many years ago. Nothing so drastic but the "Lawyer" put a stop to it...Call a lawyer and speak to him and tell him the entire story...(no cost to you..). Keep an eye on your Lc. Check it weekly if it stays good it will show and you will know if something has occurred. They use scare tactics but so can you....Let them make the first move... I hope you do not need any of these things but people like this can be vindictive......I might have gone a little overboard but forewarned is forearmed and don't let stress get the best of you as it might never happen.....

Specializes in Emergency.

Where were your coworkers in all of this???? They should have divided up your assignment so that you could've gone home. I can understand why a DON would refuse report when they are in charge of the house and couldn't possibly perform bedside care.

I consistently advise nurses that if they are not feeling well while on the job, they should report to Employee Health or the ED in order to obtain documentation to validate their claims. That information they would use in their favor in the event management decides to hand down a discipline.

As to whether or not she committed abandonment, I would say so. Walking out of the job without a proper transfer of care, regardless of leaderships knowledge, could be seen as abandonment. Proper hand off would be to another competent nurse on the same unit or one floated from a similar unit. The BON of any state is comprised of RNs and if the responses on this thread are on either side of the fence, then the same could happen under review. Not worth the trouble, next time, take the potential discipline then risk smudging your license.