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.

Specializes in Geriatrics, Dialysis.
siegolindoRN said:
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.

I believe OP was working in a SNF. This is a way different situation from a hospital. There is no available staff on the same or a similar unit. The norm is one nurse to one very big unit. Unless this was a very unusual SNF there is just no staff available to pull. There should however be unit managers, MDS coordinators, and if all else fails both the ADON and DON. All nurses, all capable of working a med cart for a shift. The only time I can see all of managment having a legitimate reason to not be able to jump on the floor is if State were in the building.

We had one of our nurses sit at her desk and die. Go home if you're sick. You'll only make the other nurses sick and possibly your patients also. Besides, who wants to die at work........just nasty.

Wow I find this unbelievable!

In the UK nurses, quite frankly, take the piss. I have had nurses leave a shift due to being unwell, not coping or having personal issues. Nobody bats an eye. Your colleagues are just left to clean in the mess and look after double the amount of patients. Management may send some help, but chances are every other area is hideously short staffed.

In the UK you have to perform

some horrifically unsafe task and mean to do it before getting fired. Actually getting fired is pretty unheard of.

Specializes in Trauma ICU.

With staffing being such an issue I would rather call in, even if it was late then go to work and hope they could find a nurse to cover my patients so I could leave. The reality of the matter is that we are often so short staffed that there is no way to safely cover a sick nurses patients if they need to go home. Short notice is better than nothing and I'm happy to take the demerit points (or written warning) rather than be potentially accused of abandonment. I have worked nights where we really had to let a nurse go due to illness and it resulted in a nurse taking on 3 ICU patients, while the whole unit pulled together it was not safe. The management really did try to find a nurse to take over the assignment but there were none to be had. I would always advise anyone if you are questioning when you get up if you can make it through a shift, just call off, there is no point in being a hero and sometimes it can be worse to try and find a way to let you go if you really are badly off.

Any place I worked the floor nurses working with her would've at least split up her patients. That's horrible

Specializes in LTC, NEUROLOGY, REHAB.

it is an unwritten law that nurses are not allowed to be sick. EVER. You may call in dead only with 6 months prior notice. I personally had a few more sick days than usual last year - due to problems after several minor surgeries at the very hospital where I work.....and I got the lecture from my manager. Then another sick day occurred and now I am on some kind of "watch" list. All this in the pretense of caring for the staff member, when in fact the only concern is covering the shifts. What happened to you is a disgrace. The fact they were unable to find a replacement when given so much prior notice is also a disgrace...I wonder how much effort was actually made? You should sue for wrongful dismissal. Something else has been bothering me for some time now with U.S. based employees posts of this nature where employers are essentially bullying them...and that is the lack of nursing unions. Do you not have unions affiliated with the licensing bodies? Are there no other unions for health workers at all levels to join? Here in the UK we have both, and they carry a lot of clout! Workers should be treated with respect.

Kimmye66 said:

I remember being so sick and coughing at meeting where the DON was yelling at everyone for calling in sick ( everyone had the flu) This was when flu vaccine not readily available and in nursing school I was taught that you had to go to work sick and never left your patients without relief. That was back then. Now if I am ill I don't want to pass it to my patients or co workers, also I want to make good judgement calls. You can't do that sick.

The supervisor should have sent you home and took care of your patients until relief was found. I am sorry what you are going thru, I doubt they can get your license revoked, that would be a long process and vindictive as well. Take care

and I hope you find a job soon!

Next time just call off.  It is not "too late" to call off.  If you are sick, you are sick.