LPN left facility to get coffee-License suspended for patient abandonment

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

Published  

I am looking at a suspended license for 6 months for "abandonment" leaving a facility I was working at through agency for only the 2nd shift. Evening shift. It was a 133 bed LTC facility of which 47 were mine. In this type of facility  you don't really get report. You count narcs, take keys & the previous nurse leaves. (Worked at over 100 facilities & they were all basically the same on that) so anyway, off going nurse said make sure you take your lunch, mgt was upset last shift you worked bc you didn't take a lunch break.

So I after 5pm med pass I went around asking everyone if they wanted anything from the store & that I was going to get coffee. NO ONE EVER SAID YOUR THE ONLY NURSE. I ASSUMED that having 47/133 pts there was another nurse in the building. (My mistake) I was gone 7 min from start of finish, didn't even get coffee dt phone call from one of the CNA's screaming & cursing me that I need to get back & I was the only nurse. When I got back, the DON was already there and they sent me home plus only paid me for 2 hours. (My last note was at 620pm. Started shift at 245pm) over a year later I get called by the oksbn wanting to suspend my multi-state for 6 months (licensed in AR W/ multi) $500 fine + cost of investigation, 1,000 hours of working under another nurse to prove competency, 100 hours of education, & I can APPLY to get my multi-state back after this is all completed. Newest news is, I'm up for renewal next month & AR will not allow renewal if under investigation for complaint. I sit in front of the board end of this month & my license will expire end of next month. I guess my question is, how do I deal with this? I know I made a mistake & will definitely make sure I'm asking titles of everyone going forward. How do I keep from getting my license suspended over an HONEST mistake?

Also, what can I do with my skill set for LPN if not nursing? I've been in medical field since I was 15 years old. I don't know anything but nursing.

Share this post


Specializes in Tele, ICU, Staff Development.

This is really an unfortunate situation. I feel for you even if your judgment is in question.

There's a lot to unpack here, and you have much at stake. 

You ask, how do you deal with this? You deal with this by retaining counsel, demonstrating accountability, and showing remorse for putting your patients at risk. 

Accountability

Accountability is key when approaching the BON, and you must take this seriously.

There are multiple signs here that you do not understand the gravity of the situation.

  • One is your sentence in capital letters: "NO ONE EVER SAID YOU WERE THE ONLY NURSE." It is not others' responsibility to tell you not to abandon your patients. It is not others' responsibility to tell you to give handoff report to another qualified professional. Exactly who was in charge of your patients when you left the building? 
  • You imply you left the facility because the offgoing nurse said you didn't take a lunch break the day before. This was your decision and yours alone.
  • "I was gone for 7 minutes from the start to the finish; I didn't even get coffee".  Are you saying it was OK to abandon patients for 7 minutes? What if it was 10 minutes or 15 minutes? Where do you draw the line?
  • Saying it's an "HONEST mistake" is minimizing your action. An honest mistake is forgetting to clock in. Deliberately choosing to leave the facility to get coffee is not.

Not taking accountability will very much hinder you as far as the BON is concerned. Your patients were abandoned without any defensible reason.

The points above are things you need to think about before your hearing.

Attorney

You should not try to navigate this without an attorney. Remember that BONs are not on your side. Their job is to protect the public, not nurses. The job of an attorney is to protect you. When you retain an attorney, get one versed in AR BON. Here's a link to The American Association of Nursing Attorneys. Do yourself a huge favor and get an attorney.

Alternative Career Paths for LPN Skills

If your license is suspended, knowing your skills are still valuable in many non-nursing roles is good. Here are a few options:

  • With your extensive healthcare experience, you can transition to managing medical practices, clinics, or assisted living facilities. As an administrator, you oversee day-to-day operations and handle staffing, budgeting, and possibly patient care coordination without direct hands-on nursing.
  • Your experience in various healthcare settings, including working with agencies, would make you an ideal candidate for a healthcare staffing agency or HR department in a hospital. You'd be responsible for hiring, onboarding, and managing medical personnel.
  • If you've been responsible for organizing patient care, this could translate well into a role where you manage care plans and coordinate between families, doctors, and insurance companies. You can often find these roles in outpatient settings or insurance companies.
  • Health education is where you can still use your nursing knowledge to educate patients or communities about healthcare topics, hygiene, nutrition, or disease prevention. This can often be done in a community or outpatient setting.
  • Medical sales—especially for equipment like wound care supplies, mobility devices, or pharmaceuticals—could be a good fit if you want to move into a non-clinical area. You already know what's needed in healthcare, and a sales or customer service background can help build your resume.
  • You could transition into home health care consulting with your experience in LTC (long-term care). You could work with agencies to improve care, ensure regulatory compliance, or even help develop training programs for other caregivers.
  • While this is a step down from nursing, your clinical experience could still make you a valuable asset in direct patient care (non-nursing) roles. Working as a personal caregiver for high-needs patients, particularly in a non-hospital setting, may give you flexibility while still providing meaningful work.
  • If you enjoy teaching, you could work as a nursing assistant instructor or train other healthcare staff. Many educational institutions or private companies hire professionals to teach specific healthcare skills, such as caregiving, medical records, or CPR training.

Final Thoughts

You've had a long and successful career, and while this is undoubtedly a tough setback, it's not the end of the road for you. The key here is to approach the board hearing with honesty, accountability, and a clear plan for how you've learned from the situation.

In the meantime, it's wise to look into non-nursing roles that utilize your skill set to ensure you can still work and support yourself while this process unfolds.

Best wishes,

Nurse Beth

Sorry to hear this happened to you. These facilities wonder why they can't find staff. I wouldn't even consider working with these patient ratios. Every state has laws about breaks. In my state, employees can't be legally required to stay in the building if they are off the clock and UNPAID (employers have to pay you if you're required to stay in the building). Our X-ray techs take an unpaid break and our patients have to wait during that half hour. You definitely need an attorney. Good luck.

If you only had 47, who had the rest?

Things like this are exactly why I can't at all understand why people are OK working in these facilities  - you had 133 patients and didn't even know. The fact that this could even happen in the first place is insane - why does anyone work in a place where this even has a chance of happening? 

 

So they only paid you for 2 hours and you were there for more than 3 hours? Find an unpaid wage and hour violation attorney since you are owed money. 

Specializes in ICU.

Was there not someone for you to report to? Is an RN not required to be in the building 24/7? I think there should have been someone in a supervisory position for you to report to who would have decided whether or not you could leave the building. It seems that the whole situation is messed up

Specializes in Med-Surg.

So, when you left the building, you took the narcotic keys with you?? In a total of 7 minutes, the DON was already onsite and a CNA was summoning you back to the building? The CNA had your (an agency nurse) personal cell number? Is the CNA a personal associate of yours? Was the DON lurking in the shadows waiting for you to drive off? You've worked 100 facilities and you never made rounds before accepting the unit to make sure there was adequate staffing in the building in the interest of patient and YOUR safety?? As an agency LPN, you didn't bother to check who your partner(s) was/were should there be an emergency situation with a resident? Speaking of which, did someone code in the 7 minutes you were out of the building??

There's so much more to this story in my opinion. An experienced nurse does not make these types of mistakes. But then again, you mentioned being in healthcare for 15 years, not being an LPN for 15 years. Even a new grad would want to know who the resource person is should she or he encounter trouble.

The total lack of critical thinking in your account of what happened would disqualify you for ANY of the positions that Nurse Beth mentioned if I was the hiring manager. (Mind you, I said "in your ACCOUNT of what happened", not that YOU lacked those skills). I think you are purposely omitting key details...details that might refer you to McDonalds, and the like, versus other healthcare opportunities..

I say this as an RN of 15 years, who worked countless shifts as an agency/float pool LPN of 24 years. Some things are so second-nature after working "100 facilities" that there is no way they could happen over a cup of coffee. I think you are planning for a future that no longer includes licensure and if so, that same future may or may not include healthcare altogether, depending on actual events that were uncovered. 

Again, my thoughts mean nothing in your world or anybody else's other than my own. Just be mindful that advice based on half-true or untrue scenarios will only waste your time.

 

Specializes in hospice.

There is way too much left out of this story for an outsider to really grasp what really happened.

Specializes in Psychiatry, Community, Nurse Manager, hospice.

I understand that some SNFs do not have a culture of giving report (and I think that's terrible) but in the very least you have to accept the keys, and handoff the keys.  You can't go on break until you have someone to give the keys to. If you don't have anyone to take the keys, then no break. It doesn't matter who gets mad about that. You can't leave your patients. So that was your mistake. One time I had to stay 4 hours past my shift at a SNF because no one came to relieve me. I was highly angry about it, and I never went back to that facility, and you better believe they paid me overtime, but I didn't leave until another nurse came. Such is our lot as nurses. It wasn't so much that you assumed there was another nurse there that was your problem. You need to know who that person is and transfer the keys to them, hand to hand, to be sure that they understand their responsibility. That's where you messed up.

Anyway, I agree that you need a lawyer and that you have to be contrite if you want to be spared the long arm of the BON. I also agree that you should fight to be paid for your time, if you accept the diminished pay, you are essentially admitting to not being in the facility at that time. 

It's absolutely crazy that nurses are regularly being expected to take care of that number of patients in LTC, but this is what is happening. I won't pretend that these ratios are fair or reasonable because they aren't. 

Dear anonymous,

I find it surprising that with your experience of working at more than 100 facilities, you didn't learn to ensure that your 'back was covered.' During my time as an LPN, I always made it a point to understand the 'rules' and peculiarities of the places where I worked. I feel bad for you that you are going through this. Please make sure you retain counsel. As far as suggestions for your future, I think that Nurse Beth has given excellent guidance.

What kind of disgusting facility/agency exists where the nurse has 47 patients ??

Nurse Beth said:

so anyway, off going nurse said make sure you take your lunch, mgt was upset last shift you worked bc you didn't take a lunch break.

So I after 5pm med pass I went around [...]

I am sorry....the end of the above sentence surprised me as I was reading.

I surely thought you were going to say "...checking with appropriate peers (eg other nurses and/or supervisor) to make sure it was an okay time for a break" or something like that, and letting them know that you planned to take your break.

Seeing if anyone wanted anything from the store is not what I expected to read next.

We don't all need to kick you while you're down and I don't mean to do that. I DO actually understand what you mean as far as how things roll in these places and why you made the assumptions that you did. But for the patients' sake, and because of your license, you must always ensure that patient care is covered. If a place is so disorganized and chaotic that one could unknowingly be the only nurse present in a facility of  >100 pts, that's insane and is not a place we should work.

In this case it doesn't sound as if you even took steps to ensure that your 47 patients would be covered while you were on break.

Nurse Beth has given you very good advice. Though it may be hard to hear it is probably imperative that you try to process it and reframe what has happened. Try to be professional and concise in speaking about this as well; the tone of your post/inquiry is cavalier to your detriment.

I'm sure this is a lesson learned. I hope you are able to navigate what lies ahead and come out in a better place.

 

I feel for you. It could happen to anyone. I don't understand if there were other nurses in the facility, where were they when this happened? Were they on break?