Legal obligation for disaster relief

[kardz30]

I belong to a level 2 trauma center in florida. I've had my arm twisted into a "disaster relief team". I've been told that I will remain in the hospital for 1-2 days, possibly more. That I am not allowed to go home or leave. That I must stay within the confines of the hospital.

When asked, I asked for the policy per employment or the statute/law, or any literature at all that obligates me to stay in the hospital and force me to perform as a nurse or just stay within the confines of the hospital. No one could cite any resource or source.

I am wondering if anyone knows of what law, statute, or area in the nurse practice act that cites the scope and exact legal obligations there are for hospitals to dictate this? As far as I'm aware there are none, but I know many other nurses have faced this being Florida and that they have families and homes to tend to during storms/hurricanes while not on their scheduled shift.

Please, do not go off topic with "moral obligations" and this and that. I am ONLY looking for a law or literature that says nurses are legally obligated to perform during a disaster in the state of florida.

[CharleeFoxtrot, BSN, RN]

On 9/4/2019 at 7:56 PM, hherrn said:

That's a problem with a nursing site- you ask a question about law, and you get a bunch of answers from a nursing perspective, which, of course, will focus on nursing ethics and morals.

It helps if you think of this as an NCLEX style discussion. The answers may all be correct or may not be correct but pick the most correct one out of the bunch ?

[Sugarbear55]

I am retired. However, living in a coastal town, I have been subject to lock down due to impending severe weather. After the first experience away from my family for days , I decided if I must stay, it would be on my terms. The next hurricane, I brought my entire family including the cat to the ED lounge. Needless to say, my nurse manager was not a happy camper. Her alternative was to send me home. My family was settled in a patient room in the tower after extracting a promise from my spouse that the cat would be contained.

[ORBSN, ADN, BSN, CNA, RN]

The answer to the question in my opinion is this : know your state’s nurse practice act (abandonment) and know your facility’s policy and procedure as it relates to disaster coverage. Do not sign up for coverage you don’t understand or to participate in anything you have doubts about. My suggestion is talk to whoever is in charge of your disaster coverage and explain you need to withdraw, due to not really understanding the whole picture. There might be someone who really would like to step up for the overtime and experience. As far as physical evidence of law I doubt your going to find any. There will be consequences if you don’t show or if you leave before relief arrives. We had multiple shifts stay over and after our shift we were given a room and allowed to sleep. Cafeteria stayed open until we lost power and were on generator power. But the hospital did provide food even after that. Flushing toilets became an issue and air conditioning. The experience was one I will never forget and I helped deliver by c-section a baby during the hurricane. Sort of cool.

[Guest219794]

Interesting thread with two intertwined themes:

I will never sacrifice the well being of myself and my family. Unless I get paid a whole lot more.

To me, these would be separate issues.

[Jkloo]

3 hours ago, hherrn said:

Interesting thread with two intertwined themes:

I will never sacrifice the well being of myself and my family. Unless I get paid a whole lot more.

To me, these would be separate issues.

I don't know. I suppose if the disaster was completely unpredictable, then yeah it would be fairly separate. In the southeast with hurricanes...there is at least a fair amount of predictability to them. Increase the pay or find other incentives and there will be plenty of single people willing to stick it out, or others from around the country willing to come in for relief. As I said earlier the increase in financial rewards are common with federal law enforcement, contractors, insurance agencies, you name it...

Not only that, but the financial pressures would encourage hospitals and other settings to actively transfer their patients to refuge rather than just rely on internal staff working under threat...

[NurseSpeedy, ADN, LPN, RN]

On 8/31/2019 at 2:10 AM, kardz30 said:

Cool beans, only a few people actually said something specific instead of speaking to generalities and without going off topic. ORBSN, Jedrnurse, thanks for the answers.

Muno, I don't know what condition of my nursing license obligates me to work more than 12 hours. The simple reality is I don't work on generalities because a few states have laws on the books. I'm also not a robot, I want to know the specifics and scope of those laws. I don't listen to government or employers, really any entity at all blindly. I've got my own personal endeavors to be concerned for, and will be concerned for them...but I can't be expected to stay in a hospital for any excessive amount of time beyond what law requires (14? 16? hours).

No one is citing anything per law or policy. In fact the issue isn't my schedule changing or anything, it's really just being "forced" to stay within a hospital for far more than a shift and some extenuating circumstances in mind, pay or otherwise. At which point labor laws become an issue.

As in anything, it doesn't matter who you are...you can't just demand things arbitrarily and expect people to follow it outside of whats reasonable. Keeping employees confined for 3-4 days is unreasonable. At least it is without laws or policy either from a healthcare agency or a statute. The only thing I'm asking is for the literature that backs it up.

There are people that think I'm somehow obligated by virtue or because a few states will arrest you, or because I'm a nurse and that's what nurses "do". I don't play the virtue or generalization game. Literature, literature, literature. If there's rules show me the rules, otherwise don't force me down a path. I'm not cattle. In this field, you have to know the law or be willing to question what the law/policy is or you'll potentially lose your license at some point or get taken advantage of. Being a nurse might be a noble thing, but the industry most certainly is not.

Karen, ethics are just propaganda without a law to back them up. It's all virtue signaling of what "ought" to be.

The one thing they can get you for is patient abandonment if you leave and no one is there to take report/take over your assignment.

I’ve been through several storms. Each one the facilities where I worked offered a sheltered area for staff to sleep, shower (providing there was running water) and shifts were 12-16 hours. I was never mandated to stay as long as my relief showed up at shift change, but you better believe if I left I better make sure my butt was back in that place on time for my next scheduled shift. I was also flex pool so I wasn’t exactly “staff” where the facility chose my hours, but once I committed to my schedule, long before the storm ever formed, I had to be there. If not, I’m sure I would of been canned. We didn’t have team a, team b. We had-if your scheduled to work when it hits that’s your rotation.

when Irma hit the facility I worked for two days a month PRN tried to tie me into a 72 hour team. They did this preparation for storms while Irma was approaching, probably because no plan was in place because we never had a bad storm actually expected to hit us until then. I also had another job at the time, hence why I was two days a month PRN. I got to work and was told, “Oh yeah, you weren’t here so I just put you on team B”. My response, “I work two shifts a month PRN. I’ll work longer if I scheduled myself during the storm or whatever, but I’m not working extra after the fact.” I was then told they were going to check with HR to see if I HAD to, bring licensed. I told them to go ahead, and if the storm did hit and destroy my home that my husband would be accepting a job transfer to the northeast. Either I called their bluff or HR told them they couldn’t force me to work after the storm if I wasn’t scheduled because I heard nothing else about it.

So, I cannot speak legally, but patient abandonment is the only thing they could use. If you reported off on your patients to your relief (assuming they came in to work)then you didn’t abandon them. The hospital CAN fire you and resisting could place a target on your back to get you canned-so you have to be ready to not have that job anymore if that was the case. I was in a position where I was freaking out, this wasn’t my main source of income, and there was a decent chance I would not have a home after the storm passed if it went the way it was looking. My husband was offered a transfer out of state and was considering it. So, my situation was basically screw this I’m protecting my family. I woke up at 6 am the next morning and it was tracking right for us. Me, my husband, and young daughter ended up in a hurricane shelter overnight. I did not sleep. I was watching over my child in a room full of strangers. Luckily, we only got 100mph winds and my home was intact. I did what I had to do for my family so I totally get why you want to know what your legally obligated to do. Don’t abandon you patients and you should be fine...just make sure you have a plan for if you don’t have a job if you don’t comply with their demands.

[kbrn2002, ADN, RN]

While I am not in an area known for natural disasters I am in an area known for snow storms. We have a "storm policy" that expects all staff to be on-call and to come in when needed. I successfully protested that policy by simply pointing out since they weren't paying me to be on call I wasn't obligated to sit by the phone waiting for notice to come to work.

Do these mandatory disaster response teams in hurricane zones pay the relief team nurses for being on-call or are they just expected to put their lives in danger waiting out a storm until they are expected to go to work? I sure wouldn't compromise my own or my families safety by not evacuating because I am needed at work after the storm passes. Any policy that requires this kind of nonsense should also have a plan that ensures the safety of not only the nurse but that nurses family including pets if they are expected to ride out the storm until they are needed at work.

[Kooky Korky, BSN, RN]

On 8/31/2019 at 4:00 PM, brownbook said:

Thank goodness for nurses with your attitude. I feel so reassured that I or my loved ones will be taken care of in the event of a disaster ?.

I hope you or your loved ones aren't in a disaster some day, rushed to a hospital and told you will have to wait hours to be seen or that it might be best to go to another facility, there is not enough staff available as no one was willing to come in on their day off or stay overtime.

This is exactly the type of response OP asked to not receive.

I hope we all have all necessary staff if/when we personally need them. But life has a way of upsetting the best laid plans of mice and men. People do, after all, die in God-created disasters all the time -hurricanes, fires, tornadoes, criminal thugism, floods, meteor strikes, tsunamis, (yes, God does create/allow all of this stuff).

If a hospital is going to force workers to not leave the hospital at all when they are not actually engaged in working, related to a disaster, it has to pay those workers and give them food, a place to wash and rest, and provide other basic necessities, like clean scrubs and maybe a means to contact their own loved ones (or have those loved ones with them at the hospital, including pets and people they normally would be caring for). That might not be law but it is good sense.

OP, find out the answer from a couple of attorneys in your state.

[Kooky Korky, BSN, RN]

On 9/4/2019 at 4:22 PM, CC Girl said:

I can't even believe your post. Are you serious? People have lost their whole LIVES and loved ones. Their lives are destroyed. You are here asking for rules and regs because you are INCONVENIENCED and being "made" to work OT to help in a DISASTER?? I understand and respect those who stand up for their boundaries and rights, but are you even HUMAN? Unbelievable. I don't care if you read or ignore....but this needed to be said.

I hope you are as passionate about places that force nurses (only because nurses allow it, BTW) to work without breaks, proper equipment and supplies, and lack of respect from and disobedience by subordinate staff.

[Crash_Cart]

On 9/5/2019 at 7:25 AM, ORBSN said:

The answer to the question in my opinion is this : know your state’s nurse practice act (abandonment) and know your facility’s policy and procedure as it relates to disaster coverage.

You can't abandon a patient if you aren't taking care of any in the first place.

[THAT Nurse., MSN, RN, APRN]

On 8/31/2019 at 6:10 PM, no.intervention.required said:

Agree 100 percent here. If you take report and not relieved 12, 16, 24? hours later, you are legally stuck, and may face abandonment charge. But, if you don't show up to work, you will most likely to be fired, that's all. Choose your option.

Personally, I would make sure my family is safe before taking any report on the patient.

Its been said in a few other posts, know your state practice acts, and I would add know BON Position statements if your state has them.

Having started my career in TN, I will use theirs.

https://www.tn.gov/content/dam/tn/health/healthprofboards/nursing/position-statements/Nursing Position_Statement_Booklet.pdf

Regarding abandonment/license threats...

Quote

A nurse - patient relationship begins when responsibility for nursing care of a patient is accepted by the nurse.

The following will not constitute patient abandonment:

Failure of a nurse to work beyond her/his scheduled work shift

Refusal to accept an assignment or a nurse - patient relationship and failure to notify the employing agency that the nurse will not appear to work an assigned shift

Failure of a licensed nurse to comply with a facility policy involving mandatory overtime, refusal to accept an assignment or a nurse patient relationship

Failure to notify the employing agency the nurse will not appear to work

Failure of the licensee to provide the employer with sufficient notice of intent to end the employment relationship.

Do NOT let fear drive you into making decisions. Whatever state you are in, know what is legal. Early in my career I had a nurse manager order me to change my personal signature saying it violated board rules ("I cannot make out every letter in your name"). I demanded she show me the rule. No rule existed. It then became corporate policy, again demanded policy to review, which didn't exist. Then it was because I told you so, and I simply walked away laughing at her.

Also OP, often times board regs permit punishment of nurses for nebulous rational.

Again, using TN...

Quote

(a) (1) The board has the power to deny, revoke or suspend any certificate or license to practice nursing or to otherwise discipline a licensee upon proof that the person:

(A) Is guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing;

(B) Is guilty of a crime;

(C) Is unfit or incompetent by reason of negligence, habits or other cause;

(D) Is addicted to alcohol or drugs to the degree of interfering with nursing duties;

(E) Is mentally incompetent;

(F) Is guilty of unprofessional conduct; or

(G) Has violated or attempted to violate, directly or indirectly, or assisted in or abetted the violation of or conspired to violate any provision of this chapter or any lawful order of the board issued pursuant thereto.

(2) This section shall also apply to members of the board.

So those other posting posting ANA Code of Ethics? They ARE posting the standards you will be held accountable to if no specific law abrogates the codes of our profession. It's been over a decade, and I still remember my instructors drilling that into my nursing student brain.

[Horseshoe, BSN, RN]

I don't understand why the OP agreed to be a member of a "disaster relief team" when she had no intention of showing up in the event of a disaster.

Learning how to say "no" is an essential skill and would have saved her all this grief.