If a nurse leaves the unit without telling anyone...

[mom1965]

At what point is it considered abandonment? We've starting having issues with several nurses leaving the unit at once..usually what happens is one out of the group will say he/she is going to lunch but then the rest of us realize (too late, of course) that 2 or 3 have gone with that one person! And they never tell anyone that they were going....you just realize all of a sudden that the staff-patient ratio has taken a dangerous turn.

You would think that grown professional adults would know better but not so. It is all "me,me, me"

Management has been notified but it keeps happening over and over. And it's not like the offenders do "just" a 30 minute break, they are gone for an hour or more. The charge nurses are pretty weak and turn a blind eye (or they are among the group that leaves!), couple that with the unit politics, etc...the issue never gets addressed/resolved

Thanks in advance for any advice!

[thompd01]

I work in the ICU. In our policy we have a minimum number of nurses that should be in the unit when their are patients (that number being 2 for a 12 bed unit). Therefore, whenever anyone wants to leave the unit they must get permission from the charge nurse. It's the charge nurse's responsibility to make sure that at all times the unit is staffed appropriately for patient safety.

However, if your charge nurse isn't doing her/his job and you don't feel your manager is taking care of the situation, you should climb up the chain of commands. This isn't a matter of your personal needs. It's about what is right and safe for the patient. As nurses, it's our job to care for patients and be their advocate.

Another solution I have see on other floors is the buddy system. At the beginning of the shift, two nurses are paired. If one of these nurses leave the unit the other must stay in the unit to care for their patients.

Good luck!! Remember it's your job and duty as a professional nurse to be the patient's advocate.

[jadelpn, LPN, EMT-B]

At the begining of the shift lunches are scheduled, and the nurse taking over for the other's lunch is noted. Sometimes we all don't get a lunch, so an hour is a bit excessive. I would think that if a group goes for an hour, then the charge nurse needs to be made aware, and can take the patients that are without a nurse. I think an hour with 20 patients or so, and charge may change her tune. In all seriousness, if something happens to a lunching nurse's patient and a report off was not given, this is a significant issue. If a med was missed by the nurse due to lunching without coverage, it is an issue. Sounds like the charge needs to....well.....take charge. If you have unsafe staffing reports, I would use them. If you have an incident reporting system, use it. And keep using it until something changes. This is not a personal thing, it is a patient safety thing.

[GitanoRN, BSN, MSN, RN]

honestly, this unacceptable we nurses rely upon each other in order to get the job done, if someone goes to lunch another nurse takes up the load and vice versa. having said that, if a nurse leaves without notifying anyone it's abandonment in my book, and the one who truly suffers is the patient who's left uncared for. therefore, at the beginning of every shift your charge nurse has the task to assigned your relieve during your lunch time and breaks, needles to say, these two may be difficult to take at times. however, one must take a recess in order to get away even if it's only for 15 minutes it does wonders to place ones mind in perspective. moreover, if management has been notified regarding this issue then it's their responsibility to make sure that everyone is accounted for and their task is adhere to the letter. however, if the problem persist then it should be brought up in writing to your management, and address in a meeting. in conclusion, the key word is communication if all else fails this should never be taken for granted.

[maelstrom143]

Leaving the floor for any reason without reporting off to someone is considered abandonment. Without a heads up your patients have no one to rely on while the nurse assigned to them is gone and that could prove catastrophic to their wellbeing. It is definitely an incident report, in my opinion.

In addition, taking longer than is alloted for our breaks takes advantage of those left on the floor and may not allow them a break, even though they have earned the right to get that break. If you are missing your breaks due to inconsiderate coworkers, start filling a "no lunch" slip each time you miss it and explain on the slip why (i.e. other nurses off floor caused inbalance in breaks). Administrators start getting unhappy when they have incident reports and missed breaks piling up. jmho.

[caliotter3]

Start making out the incident reports and missed breaks slips and make copies for yourself. Eventually, this could reach a third party, such as the Labor Board or an attorney, and you will need evidence. I was amazed the first time I read of a class action lawsuit brought against an employer for missed breaks, etc. You tell yourself you won't go that far, but you want to be prepared. One never knows what is around the corner. A wise supervisor will know what the paper trail could lead to and will be forced to take appropriate action.