Leaving home patient for own health emergency

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I work as a private duty pediatric nurse under an agency. I am 7 months pregnant and had a personal emergency today. Last night one of my feet swelled to twice the size of the other. When I called the doctor in the morning he told I need to come in for a doplar of my leg right away. I was already at a patient's house for a 12 hour shift. I called my agency and the said they would look for someone else to come out and replace me. How long should I wait and if I leave without a replacement is it abandonment. Stressing about potential danger to myself and baby for waiting but don't want to lose my license.

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Specializes in Complex pedi to LTC/SA & now a manager.

Yes it's abandonment if you leave (especially without a competent caregiver in the home) without a replacement. It can take an hour or two for the agency to find an available nurse and the nurse to get to the case. If your clinical manager approves and the parent/guardian is home and can care until a replacement arrives it's not abandonment.

All of my clients have a list of competent caregivers listed in the chart that can safely care for the child in an emergency.

Communicate with the clinical manager.

If your leg swelled last night why didn't you call your physician then for advice? You could have had a stat Doppler last night and if need be, called off and the agency would have a little more time to scramble for a replacement.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Moved to our Private Duty Nursing forum for best response.

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You can not leave the patient alone or without competent care. You should not have reported for duty under these circumstances.

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Different state board of nursing have different definitions of abandonment. Please consult your board of nursing for their definition.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

Its abandonment. Just plain wrong to leave a child unattended. However, its wrong for you to be in your own emergency without someone to cover you. Your agency should figure it out or get the parent to go home. On another thought, what if you had to call an ambulance? Who would care for the child then? Lets say a nurse had a heart attack and called EMS...would an untrained officer or EMT stay?

......downsides of PDN.

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As someone else stated different BONs have different rules and each is reviewed on a case by case basis. That said, I would sit on the neck of the agency until they got someone or the nurse manager of the case came in or they gave me the competent caregiver to leave the patient with. Hope everything is okay, please let us know.

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Specializes in Pediatrics.

My understanding is that a medical emergency is a medical emergency, and an immediate life-threatening situation negates patient abandonment. OP would be going to the doctor, not the ER, so it would be urgent, but not necessarily life-threatening.

My agency wouldn't take issue with calling out. What they would have a serious problem with is the fact that the nurse reported to work with a worsening medical condition.

This is many hours later and I'm sure the matter has been resolved. I really hope OP is okay and will update!

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Specializes in Complex pedi to LTC/SA & now a manager.
My understanding is that a medical emergency is a medical emergency, and an immediate life-threatening situation negates patient abandonment. OP would be going to the doctor, not the ER, so it would be urgent, but not necessarily life-threatening.

My agency wouldn't take issue with calling out. What they would have a serious problem with is the fact that the nurse reported to work with a worsening medical condition.

This is many hours later and I'm sure the matter has been resolved. I really hope OP is okay and will update!

But if the nurse is alone with the client, under no circumstances is it alright to leave a medically complex child home alone. It would be abandonment and child neglect. The prudent choice would have been to contact the physician the night before when the spontaneous unilateral edema started and CALL OUT for the shift if needed. It was not a wise or safe mood to wait it out , go to work and THEN call the physician. She wouldn't be at risk for abandonment and neglect if she called when the issue started.

If the parent or another competent caregiver is home or nearby, then she could call the agency advise of her emergency and leave client safely in the care of a competent family member.

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Specializes in nurseline,med surg, PD.

I've always wondered about that type of thing. What if a nurse had an MI or aneurysm and you're alone with a dependent patient? I guess both people would just be out of luck.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

I guess a conscious warm body without training is better than the unconscious or deathly sick trained person.

If I were the parent, I'd rush home (can you imagine doing PDN and having to leave to come home for your nurse to leave and having to find coverage too?). I'd rather have an officer or EMT do the most essential things to watch my kid until I could replace the nurse. A few late meds in most cases wouldn't be the end of the world. I wouldn't want a cop trying to give all of those meds! I'd be most concerned with them maintaining the airway.

Here's another thought...many of us work 12-16 hour shifts. What if something happened at the beginning of the shift and nobody found us or the kid for that long? Maybe there should be some sort of check in place.

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Specializes in PACU, pre/postoperative, ortho.

OP, hope all is well.

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