Is it legal for a nurse to work 24 hours straight?

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Specializes in Pediatric.

Im so upset. I need some opinions and to vent...............

I work in home health and I have a client that has 24 hour nursing care. I was scheduled yesterday to work 7a-7p. At 4pm my patient was in the hospital with a fever. My on-call supervisor had instructed me to stay with the patient and if the patient was admitted I was to go home. He also said if the patient was released I was to call him so he could call the next nurse (who was on standby) to come in and take over. My patient was cleared to go home at 10pm (afebrile, all blood work normal). I called my supervisor and he said ok I will call the next nurse and call you back. He called back 20 minutes later and said she's not answering. You will have to stay until I can get a hold of her. Her shift is 7p-7a. He never got ahold of her and I told him he needed to try to get someone to come in and I asked him if they were going to seriously make me work 24 hours. He basiclly told me I couldnt leave (I wouldn't anyways because of legal issues). So I stayed with my patient until 7am the next day. My supervisor had told me I can't find someone to come in. I was soooo mad at him.....for putting not only my patients safety at risk but also my lisence.

Should I report this to my main office? Is this even legal for them to not only put their employees in such conditions but putting the clients at risk. And this was an infant client that was on 24 hour 02, had a trach and a feeding tube and was on dialysis 13 hours a day. The client required alot of attention and needs a nurse who is I just can't believe they think that is ok.

I hope this wasn't too confusing. Please give me your opinions and advice!!! :twocents:

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Specializes in ICU/CCU, PICU.

What state are you in?

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Specializes in Pediatric.

New Jersey

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Specializes in Emergency Medicine.

"Legal" is a grey area when it comes to nursing. We fall into a category like farmers and theater workers where regular shifts do not apply.

Now I don't know your company policy on such things but if I sent my patient to the hospital they are under the care of the hospital and their staff. I might have stayed for the duration of my shift to get paid but left it to the hospital for continued care.

If the patient were to be D/C'd after my shift it would be up to the company to provide coverage. My assignment would be done. They could ASK me to stay but I wouldn't feel obligated and it wouldn't be abandonment...

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Specializes in Pediatric.

My employer had told me that I could not leave until he was admitted. Which I didn't understand. I also did all his suctioning and feedings/meds while he was in the hospital. The hospital staff and my employer told me I was to do his care until he was admitted. This whole thing was a mess. I was under the impression that I could not leave my patient unless he was admitted. My supervisor did not care about my patients safety or me at all.

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Specializes in Hospital Education Coordinator.

talk to your BON. In Texas this would be mandatory overtime, and that is not legal in our state, but I am not sure if this extends to nurses outside a hospital setting. Also, I agree with EmergencyNrSe in that your "assignment" was over. Plus, the supervisor had HOURS to fix the problem. I would certainly complain to the BON. In Texas, if the agency is violating the law, then an investigation may ensue and the whistleblower is protected.

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Specializes in Pediatric.

And I was under the impression also that I could not leave my patient with anyone except the next nurse. The parents were not able to take care of the baby.

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Nope that would not be me. Is that patient 24 hour nursing care? I was imagining you having a larger caseload.

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Specializes in PACU, OR.

You need to check out the labor laws in your State. Regardless of whether you are a shift worker or not, there should be a legal maximum number of hours that you are allowed to work, and a minimum number of hours break in between shifts. If there is not, your local Unions need to get active and get it written into law.

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Specializes in Trauma Surgery, Nursing Management.

In my state, nurses cannot work more than 16 hours in a row in a 24 hour period. I got this info from my NM, but didn't look up the info from my BON regarding this.

If your manager is an RN, then they should have relieved you.

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Specializes in school nursing, ortho, trauma.

I don't understand why the 7p-7a nurse wasn't instruced to relieve you at the hospital. It's a well known fact that an admission decision is almost never made in 3 hrs. Yes, i'd be really ticked. I don't know about legality nursing license wise (some reason 18 hrs is chiming in my head - i think that's for residents, but perhaps us lowly nurses have something similar), but i do know that you are not supposed to drive a car in NJ after you've been awake for 24 hrs.

also - if i were the parents i'd be raising cain over this - i certainly wouldn't want my medically fragile child to be minded by a nurse that's been on for 24 hrs without a break.

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Specializes in PICU, Sedation/Radiology, PACU.

It appears that this is legal in New Jersey:

8:43E-8.5 Overtime procedures

(a) Except as provided for in (b) below, an employer shall not require an employee involved in direct patient care activities or clinical services to work in excess of an agreed to, predetermined and regularly scheduled daily work shift, not to exceed 40 hours per week. The acceptance by any employee of work in excess of this shall be strictly voluntary. The refusal of an employee to accept such overtime work shall not be grounds for discrimination, dismissal, discharge, or any other penalty or employment decision adverse to the employee.

(b) The requirements of (a) above shall not apply in the case of an unforeseeable emergent circumstance when:

  1. The overtime is required only as a last resort, and is not used to fill vacancies resulting from chronic short staffing; and
  2. The employer has exhausted reasonable efforts to obtain staffing. However, exhaustion of reasonable efforts shall not be required in the event of any declared national, State or municipal emergency or a disaster or other catastrophic event which substantially affects or increases the need for health care services or causes the facility to activate its emergency or disaster plan.

Here's a link to the rest of the Department of Labor statues that might relate here:

http://lwd.dol.state.nj.us/labor/wagehour/lawregs/health_care_worker_law.html

However, I would definately call your main office and explain what happened and ask what the policy is in situations like this. I'd also want to make sure that your manager really did "exhaust reasonable efforts" to find a replacement. I'd like to know why the night nurse didn't answer the phone or come in for her shift. I certainly hope there was some disciplinary action taken against her for her no-call/no-show absence.

By the way, I used to work home health and, yes, the home health nurse has to stay with the patient until they are admitted. In the ER, the hospital does not assume care of the patient. Once the patient is admitted, then the hospital is responsible.

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