legal question

meownsmile, BSN, RN · Jun 3, 2007

If you are in the building and hear a code on one of your patients,, its just instinct to go rushing back up to your unit. HOwever, if you have left your team and there is someone there for your backup while you are on break, you are not liable or responsible for what happens while you are away.

If you are on the clock you still have a right to your meals and breaks. I punch out and leave for lunch every day, but my patients are covered by another RN while i am gone.

Larry77, RN · Jun 3, 2007

Not sure the legal aspect but our policy is to not leave the hospital grounds on our 15 min breaks (like we get them in ED..lol) but on our 30 min lunch we can go off campus. It was explained to me because we are not paid for our lunch breaks they cannot ask us to stay on campus.

I thought this was interesting because we went "no smoking" on campus a couple years ago and all the employees that smoke have to go out on the sidewalk (city property not hospital campus) to light up but they may be only on their 15 min break (which all smokers seem to get...grr) which technically breaks out policy... :nono:

cheshirecat · Jun 3, 2007

Interesting question. On nights we only have 2 RN's for 32 surgical patients. When we go for our unpaid meal break at night we stay on the floor. Legally though, it means that for 2 45 minute periods in our night shift the ward is only covered by 1 RN. If anyone needs a controlled drug etc it cannot be checked. Patient must wait.

Management must agree with this otherwise they would put 3 RN's on night shift.

What angers me is the assumption we will stay on the ward without pay. Still, that is just typical of the NHS. If there was an emergency I would go to the patient immediately even though I was on break. Our managers play on the fact that as nurses we have big consciences.

Nursonegreat · Jun 4, 2007

anywhere i worked if u left the buiding fine, u just had to clock out. someone was watching your patients and if something did happen, during the period u were on break and not on the clock could not come back to get u, and that clock in and out is your only proof u werent really there.

miko014 · Jun 4, 2007

Interesting...it's a very good question. Way back in school, we were taught that unless we charted "went to lunch, handed pt over to Nursie Jean, RN", we were responsible for whatever happened. But you know, that's a very interesting point. We don't clock out for lunch, but we don't get paid for it either. They subtract a half hour off of our time per shift for lunch. Which really, is bull. I'd rather clock out and have them know that I wasn't there and be able to prove it. Of course, I eat in the break room on the unit by choice - the people who go to the cafeteria waste 20 of their 30 minute break traveling back and forth. People know they can come and get me if they need me...and if we don't get lunch for a certain day, we can write it down and they will pay us for all the time we are on the clock. But hmmmm, this gets me thinking...what if something happens while I am eating (and NOT being paid for it, even though I am on the clock).....

mydesygn · Jun 4, 2007

Ok, we were debating this last night.....When you as a nurse are given a break (which you are deducted in pay for and "encouraged" to take), are you obglitated to stay within the confines of the hospital? My postion was no, that if you assign your patients and pager to charge, or another RN of equivalent status, that you are no longer "accountable". The other side's argument was that you are still responsible and accountable for those patients, even if you are off the floor.
Any thoughts?

Actually, the main reason has little to do with patient care. Every facility I have worked for has not forbid us from leaving campus but we are told to clock out. The main reason for this is if you were to get into an auto accident or some other mishap. The lawyer will not only attempt to sue you but your employer as well claiming you were on work-related duty at the time of the accident. This actually happened to me. I was driving home from work with my hospital scrubs on and was involved in an accident with another driver. Literally, The very first question from the other drivers lawyer to my insurer was whether I was clocked in at the time of the accident. I was not but the angle was definitely clear.

Another issue to consider is that you could be in an accident or have some physical issue occur while you are away and the staff on the floor would not know. When I was a manager, one of my secretaries was gone for 2 hours and we had no idea where she was -- her children had been trying to reach her desperately. She actually had gone to pay a bill and her cell battery died. We could have paged her overhead if she had been in the facility.

A third issue is obviously not being available for questions or issues arising with your patients which places them at undue risk. Handing off a pager is simply not the same as being available to give current information on patient status if a serious event should occur with one of your patients.

I'm not saying never leave campus but do so judiciously. Send a secretary or nursing asst to pick up food off campus when possible. If you must leave then ensure you are accessible by phone for questions or issues and that you don't burden you fellow nurses every time you work by leaving them fully charged with caring for your patients each day.

As far as responsibilty for your patients while you are away -- 1) You would need to have given a complete report to the nurse assuming care for your patients as if you were going off shift and 2) the nurse would have assumed full care which implies that she had done a full assessment at the point she assumed care.

I don't see that happening since you essentially doubled that nurse's patient assignment for 30 minutes. The nurse is responsible for any care that she has given to your patients but if anything untoward happens during that 30 minutes -- you both bare responsibility, the lawyer will name both of you.

TazziRN, RN · Jun 4, 2007

We were not required to stay on campus during meal breaks. The first hospital I was at was so far away from food places that it made no sense to go anywhere, so we never got anything from outside unless we had it delivered. The last place was right next to a shopping center with several food places, and it was such a small town that even places we needed to drive to were close enough.

Working 12's, we were entitled to 30 minutes for meals and two 15-minute breaks. We were allowed, if it was slow, to combine the meal break and a 15-min break for 45 minutes, but the 15 minutes still had to be spent on campus.

jetscreamer101 · Jun 4, 2007

We are paid for our breaks, and have to stay on site for these breaks. Not that you always get a break....